Women with migraine are more likely to avoid pregnancy, especially if they have chronic or menstrual-associated migraine, are relatively young, and have fewer children; many believe their headaches will worsen during pregnancy, according to study results published in Mayo Clinic Proceedings.

Study researchers sought to determine the effect of migraine on women’s pregnancy planning. To achieve this, they conducted an observational study including 607 women with migraine who were enrolled in the American Registry for Migraine Research (ARMR) database. Participants were recruited from headache specialty clinics throughout the United States and were all women who answered ARMR family planning questions. Study researchers obtained answers to patient-completed questionnaires completed between February 1, 2016 and September 23, 2019.

Approximately 121 (19.9%) women included in this study avoided pregnancy because of migraine. The other 486 (80.1%) patients said migraine did not impact their decision to have another child. Women who avoided pregnancy were significantly younger (37.5±9.2 years vs 47.2±13.3 years, respectively; P <.001), had fewer children (mean, 0.8±1.1 vs 1.5±1.5, respectively; P <.001), and were more likely to have chronic migraine (81.8% vs 70.2%, respectively; P =.010) and menstrual-associated migraine (4.1% vs 1.0%, respectively; P =.016) compared with women who felt their decision was not impacted by migraine.

The majority of women who avoided pregnancy indicated that they thought their migraine would be worse during or just after pregnancy (72.5%). Additionally, 68.3% of this group believed disability due to migraine would make pregnancy difficult, 82.6% believed that this disability would make it hard to raise a child, 76% believed that migraine medications would negatively impact the development of their child), and 14.1% believed that migraine would cause abnormalities for the baby at birth .


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Limitations of the study included the limited participant demographic (most were white), the smaller number of menstrual migraine diagnoses, the potentially limited amount of participants with mild migraine, and the lack of concrete information on why some women chose “avoiding pregnancy” in their questionnaire responses.

According to the study researchers, the beliefs of the women with migraine “are incongruent with the evidence that migraine typically improves during pregnancy” and emphasize the importance of providing education to “women of childbearing potential with migraine…about the potential effect of migraine on pregnancy to facilitate informed decisions about pregnancy planning.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Ishii R, Schwedt TJ, Kim SK, Dumkrieger G, Chong CD, Dodick DW. Effect of migraine on pregnancy planning: Insights from the American Registry for Migraine Research. Mayo Clin Proc. 2020;95(10):2079-2089. doi:10.1016/j.mayocp.2020.06.053