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Prepregnancy Migraine Tied to Adverse Pregnancy Outcomes

Higher risk seen for preterm birth, gestational hypertension, and preeclampsia

By Lori Solomon HealthDay Reporter

THURSDAY, Feb. 16, 2023 (HealthDay News) — A history of migraine before pregnancy is associated with a higher risk for adverse outcomes during pregnancy, according to a study published online Jan. 19 in Neurology.

Alexandra C. Purdue-Smithe, Ph.D., from Brigham and Women’s Hospital in Boston, and colleagues examined associations of self-reported physician-diagnosed migraine with adverse pregnancy outcomes. The analysis included data from 30,555 incident pregnancies among 19,694 participants in the prospective Nurses’ Health Study II (1989 to 2009).

The researchers found that when adjusting for age, adiposity, and other health and behavioral factors, prepregnancy migraine (11 percent) was associated with higher risks for preterm delivery (relative risk [RR], 1.17; 95 percent confidence interval [CI], 1.05 to 1.30), gestational hypertension (RR, 1.28; 95 percent CI, 1.11 to 1.48), and preeclampsia (RR, 1.40; 95 percent CI, 1.19 to 1.65) compared with no migraine. However, migraine was not associated with low birth weight (RR, 0.99; 95 percent CI, 0.85 to 1.16) or gestational diabetes (RR, 1.05; 95 percent CI, 0.91 to 1.22). Preeclampsia risk was somewhat higher among participants with migraine with aura (RR, 1.51; 95 percent CI, 1.22 to 1.88) than among those with migraine without aura (RR, 1.30; 95 percent CI, 1.04 to 1.61) compared with no migraine. But other outcomes were similar, regardless of migraine phenotype.

“Migraine history, and to a lesser extent migraine phenotype, appear to be important considerations in obstetric risk assessment and management,” the authors write.

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