For pregnant women, "migraine is not just a neurological problem," Dr. Nirit Lev with Tel Aviv University said in reporting her findings at the virtual annual meeting of the European Academy of Neurology.
"Managing migraine in pregnancy is more complicated and needs special attention and expertise," she added.
Using electronic health record data, Dr. Lev and colleagues analyzed the pregnancies of more than 145,000 women, including 10,646 with a diagnosis of migraine and 1,576 with a diagnosis of migraine with aura.
Pregnant migraine patients had a "highly statistically significant" increased risk of high-risk admissions (6.9% in those with migraine and 8.7% in those with migraine with aura vs. 6% in pregnant women without migraine), Dr. Lev reported.
Pregnant migraine patients also had a significantly increased risk of gestational diabetes, preeclampsia and blood clots, as well as hyperlipidemia and psychiatric diagnosis.
They also sought more medical consultations and used more medications during pregnancy, had more emergency visits and had more laboratory and brain-imaging studies.
There was also a statistically significant difference in the use of epidural anesthesia, which increased from 40.5% in women without migraine to 45.7% in those with migraine and 47.5% in those with migraine with aura.
There were no statistically significant differences in the incidence of assisted deliveries or days spent in the hospital.
In terms of pregnancy outcomes, statistically significant differences were found in the incidence of preterm delivery and the number of live-born infants in women with versuss without migraine.
"When we compare specifically people with migraine with aura and people with migraine without aura, we saw that women with migraine with aura had an increased risk of vascular complications in pregnancy and were admitted more often to high risk departments and often as they sought more medical consultation both during the pregnancy and postpartum," Dr. Lev reported.
"To conclude, pregnant women with migraine are (at) increased risk of having obstetric and medical complications compared with unaffected women and there should be included in a high-risk-pregnancy protocol. These women should have specialized neurological follow-up, in addition to OBGYN care, during the pregnancy and postpartum period," Dr. Lev said.
The study had no commercial funding and the authors have no relevant disclosures.
SOURCE: https://www.ean.org/congress2021 7th Congress of the European Academy of Neurology, held June 19-22, 2021.
By Megan Brooks
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