Pregnant migraine patients at higher risk of complications

Women who suffer from migraine are at increased risk of having obstetric and post-partum complications, especially women who have migraine with aura. They should be included in a high-risk pregnancy protocol of care throughout pregnancy. These are the main conclusions of a study carried out in Israel, in which the pregnancies of 145,102 women between 2014 and 2019 were analysed.

Dr Nirit Lev (Rabin Medical Center, Israel) and colleagues aimed to assess whether women with migraine have a higher risk of developing pregnancy and post-partum complications than women without migraine, and to evaluate their characteristics and medical needs [1]. Mode of delivery, medical and obstetric complications per trimester, and use of medications throughout the pregnancy were studied. A total of 12,222 women had a diagnosis of migraine (1,576 with aura), though Dr Lev warned that migraine is not always diagnosed. The remaining 132,880 women served as control group.

In the migraine group, there was an increased risk of high-risk admissions:

• 6% in the control group;
• 6.9% in the migraine group without aura (P<0.0001 vs controls);
• 8.7% in the migraine group with aura (P<0.0001 vs controls and P=0.03 vs migraine without aura).

The risk of obstetric complications was higher in the total migraine group, this included the risk of gestational diagnosis of diabetes, hyperlipidaemia, and diagnosis of a psychiatric disorder (P<0.0001 for all). The risk of pre-eclampsia and stroke was significantly higher as well. Dr Lev noted that pregnant women with migraine sought more medical consultations and consumed more medication during pregnancy. The use of epidural anaesthesia was significantly higher in women with migraine without aura (45.7%) and with aura (47.5%) than in women without migraine (40.5%; P<0.0001). Women with migraine also tended to have laboratory examinations post-partum more often. Dr Lev recommended a specialised neurological follow-up to women with migraine during pregnancy and the post-partum period.

1. Lev N, et al. Migraine in pregnancy and post-partum epidemiological and clinical characteristics. OPR-066, EAN 2021 Virtual Congress, 19–22 June.

 

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Posted on 18 August 202118 August 2021