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Women with Migrane Are At Higher Risk of Pregnancy Complications?

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A large number of preliminary studies on pregnant women having a history of migraine suggest that they are at higher risk of pregnancy complications. It has been seen that among women with migraine and aura, the risk of preeclampsia was somewhat higher (i.e. 51%) than those women with migraine but no presence of an aura (having 29% risk). This conclusion was released by ‘The American Academy of Neurology’ on February 24, 2022, and was officially presented at its 74th annual meeting being held in Seattle in person from April 2 to 7, 2022, and virtually held from April 24 to 26, 2022.. [1, 2]

The author of the large prospective study, Alexandra Pursue-Smithe, Ph.D., of Brigham and Women’s Hospital in Boston, said that the impact of migraine on pregnancy outcomes has not been well understood. This link found between migraine and possible pregnancy complications could make both women and doctors aware of potential risks that can arise during pregnancy and help them identify and manage them at their earliest. However, detailed research is still needed to collect data on migraine aura, migraine attack frequency, and other migraine features, thus determining exactly why migraine is associated with higher risks of pregnancy complications. [2, 3]

What is a Migraine?

For those who are unversed, migraine is a type of medical concern that causes a severe form of headache characterized by extreme throbbing on one side of the head and can present itself with or without a visual aura. Auras are sensations, often visual disturbances like flashing lights experienced by a person before having a severe headache.

Migraine can sometimes result in nausea, vomiting, hallucinations, blurred or tunnel vision, and extreme sensitivity to sound and light. It tends to be frequent and long-lasting (episodic). It is commonly experienced in 10-20% of the population and is up to three times more commonly found in women of childbearing age (roughly 20% women) than in men of similar age.

Migraine Headaches do not have a definite cause. But, it is known to involve changes in the neurochemicals, nerve pathways, and blood flow in the brain. According to researchers, some overly excited brain cells stimulate the release of chemicals which irritate the blood vessels on the surface of the brain. As a result, the brain vessels get inflamed and induce a pain response.

Women with migraine experience changes in their pattern of migraine headaches due to changes in the level of estrogen hormone that is thought to play some role in migraine.  [2, 3, 7]

Pregnancy Complications Linked with Migraine:

Preterm Delivery

Preterm delivery refers to the birth of the child before women complete 37 weeks of their pregnancy. Based on the gestational age of pregnant women, there are three sub-categories of preterm delivery including:

  • Extremely preterm- when a child is given birth in less than 28 weeks of pregnancy
  • Very preterm- when babies are born alive in 28 to 32 weeks of pregnancy
  • Moderate to late preterm- when a child comes to life in 32 to 37 weeks of pregnancy.

Maternal migraine can result in preterm delivery. As per studies, women with migraine are found to have 17% higher risk of preterm delivery after the researchers have accounted for obesity, age, and other health and behavioral risk factors. [1, 5]

Gestational Hypertension

Gestational hypertension is a medical condition wherein women experience high blood pressure during pregnancy and do not produce proteins in their urine or develop any heart or kidney problems. Typically, this is diagnosed in women who are close to the end of their pregnancy or after 20 weeks have passed from the start of the gestation period. Usually, it can go after the delivery of the child. However, some women having this pregnancy complication might be at risk of having chronic hypertension in the future.

According to research studies, women with migraine are at a 28% higher risk of having gestational high blood pressure. [1, 6]

Preeclampsia:

It involves sudden or chronic hypertension and the appearance of other symptoms like protein secretion in the urine, after 20 weeks of pregnancy which could be life-threatening for both mother and the baby in her womb. Some symptoms of preeclampsia include sudden weight gain, nausea or vomiting, a persistent headache, pain in the upper stomach area, difficulty breathing, swollen face or hands, and changes in vision including eyesight problems, seeing spots, or blurry vision.
Researchers have reported in their studies that women with migraine are at 40% higher risk of having preeclampsia than others. [1, 6]

Others:

As per a comprehensive register-based study, pregnant women with migraine have a greater risk of cesarean sections, miscarriages, and giving birth to a child with low birth weight. The study also suggests that these pregnancy complications can be alleviated in mother-to-be women by using some prescription migraine drugs.

Migraine Remedies That Are Safe During Pregnancy:

Women who are pregnant are generally advised by their doctors to stay off any medications unless there is a real need for them. The right decision on the intake of drugs is important that can be done by weighing the potential effects of the drugs on the unborn baby.

For women having migraines during pregnancy, most standard treatments of migraines are safe while some can lead to pregnancy complications. For instance, some of these medications are known to cause intrauterine growth restriction, bleeding, and miscarriage. Anti-inflammatory drugs can be taken by such women on a limit. Commonly prescribed medications that have vasoconstrictive properties (ability to reduce blood flow to the brain and associated headache) include Mi-dri-n and Sum-at-ript-an. Most anti-nausea medications are also safe and effective for pregnant women with migraine. Severe migraines usually require hospitalization so that pain medication, fluids, or anti-nausea medications through IV can be provided safely to pregnant women.

It’s advised to double-check with an obstetrician or gynecologist about the safety of any medication during pregnancy prescribed by a headache specialist for migraine to prevent any complications.  [4, 7]

References:

  1. https://practicalneurology.com/news/women-with-migraine-may-have-a-higher-risk-of-pregnancy-complications#:~:text=Women%20with%20migraine%20had%20a,behavioral%20and%20health%20risk%20factors.
  2. https://www.india.com/health/pregnant-women-with-migraine-at-higher-risk-of-preeclampsia-complications-study-5261902/
  3. https://www.thehealthsite.com/pregnancy/migraine-during-pregnancy-elevates-the-risk-of-preterm-delivery-high-blood-pressure-and-preeclampsia-866096/
  4. https://utswmed.org/medblog/headache-migraine-pregnancy/
  5. https://www.who.int/news-room/fact-sheets/detail/preterm-birth
  6. https://www.cdc.gov/bloodpressure/pregnancy.htm#:~:text=Gestational%
    20Hypertension,away%20after%20you%20give%20birth.
  7. https://www.webmd.com/migraines-headaches/migraine-headaches-and-pregnancy

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