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Daily Dose: Migraine and Pregnancy Complications


Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On February 3, 2023, we reported on a study published in Neurology that examined the association between prepregnancy migraine and migraine phenotype with risks of adverse pregnancy outcomes.

The study

The analysis included 30 555 incident pregnancies after cohort enrollment among 19 694 participants without a history of cardiovascular disease, diabetes, or cancer. Among the full cohort, 11% of participants reported physician-diagnosed migraine. The investigators found, after adjusting for potential confounding variables including age, adiposity, and other health and behavioral factors, that among those with prepregnancy migraine the diagnosis was associated with increased risks for preterm delivery (RR, 1.17; 95% CI, 1.05- 1.30), gestational hypertension (RR, 1.28; 95% CI, 1.11-1.48), and preeclampsia (RR, 1.40; 95% CI, 1.19,-1.65) compared to those who reported no migraine. Migraine history was not associated with low birthweight (RR, 0.99; 95% CI, 0.85-1.16) or gestational diabetes (RR, 1.05; 95% CI, 0.91-1.22).

When they assessed incidence of adverse pregnancy outcomes by migraine phenotype, researchers found the risk of preeclampsia was somewhat higher among participants with migraine with aura (RR, 1.51; 95% CI, 1.22- 1.88) than migraine without aura (RR, 1.30; 95% CI, 1.04-1.61; Pheterogeneity=0.32). Other outcomes were found similar by phenotype.

Note from authors

"Migraine history, and to a lesser extent migraine phenotype, appear to be important considerations in obstetric risk assessment and management. Future research should determine whether aspirin prophylaxis may be beneficial for preventing adverse pregnancy outcomes among pregnant individuals with a history of migraine."

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