Migraine tied to higher risk for poor pregnancy, neonatal outcomes

  • Skajaa N & al.
  • Headache
  • 8 May 2019

  • International Clinical Digest
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Takeaway

  • Women with migraine and their offspring are at elevated risk for a variety of adverse pregnancy outcomes.

Why this matters

Key results

  • Women with migraine had increased risks:
    • Pregnancy-associated hypertension disorders (adjusted prevalence ratio, 1.50; 95% CI, 1.39-1.61).
    • Miscarriage (1.10; 1.05-1.15).
    • Low birth weight (1.14; 1.06-1.23).
    • Preterm birth (1.21; 1.13-1.30).
    • Cesarean delivery (1.20; 1.15-1.25).
  • But no significant increases in risks for small for gestational age offspring, birth defects.
  • Offspring of women with migraine had increased neonatal, postnatal risks:
    • Neonatal intensive care unit (NICU) admission (adjusted risk ratio, 1.22; 95% CI, 1.03-1.45).
    • Hospitalization (1.12; 1.06-1.18).
    • Dispensed prescriptions (1.34; 1.24-1.45).
    • Respiratory distress syndrome (1.20; 1.02-1.42).
    • Febrile seizures (1.27; 1.03-1.57).
  • But no significant increases in risks for death, epilepsy, cerebral palsy.
  • Findings similar in subset of pregnancies among women receiving migraine treatment only during second or third trimester.

Study design

  • Danish population-based cohort study 2005-2012 of 22,841 pregnancies among nonepileptic women with migraine and 228,324 age- and conception year-matched pregnancies among nonepileptic women without migraine.
  • Main outcomes: pregnancy, birth, neonatal, and postnatal outcomes.
  • Funding: Amgen Inc.

Limitations

  • Possible misclassification of migraine status.
  • Potential unmeasured confounding.