Migraine diagnosed prior to pregnancy linked to adverse outcomes during pregnancy - News-Medical.Net

Women are disproportionately affected by migraine, particularly during their reproductive years. However, the narration betwixt migraine and adverse gestation outcomes has not been good understood. A caller survey by investigators from Brigham and Women's Hospital, a founding subordinate of the Mass General Brigham healthcare system, analyzed information from thousands of women from the Nurses' Health Study II to measure the narration betwixt migraine and gestation complications. In a insubstantial published successful Neurology, the squad reports that migraine diagnosed anterior to gestation was linked to adverse outcomes during pregnancy, including preterm delivery, gestational hypertension, and preeclampsia, suggesting that migraine whitethorn beryllium a objective marker of elevated obstetric risk.

Preterm transportation and hypertensive disorders are immoderate of the superior drivers of maternal and babe morbidity and mortality.  Our findings suggest that a past of migraine warrants information arsenic an important hazard origin for these complications and could beryllium utile successful flagging women who whitethorn payment from enhanced monitoring during pregnancy."

Alexandra Purdue-Smithe, PhD, archetypal writer subordinate epidemiologist astatine Brigham and Women's Hospital and teacher successful Medicine astatine Harvard Medical School

Women are 2 to 3 times much apt than men to acquisition migraine successful their lifetime, and migraine is astir prevalent among women betwixt the ages of 18 and 44. For some, the migraine headaches tin beryllium accompanied by aura (5.5% of the population), which are usually ocular disturbances that look anterior to headache onset.

Adverse gestation outcomes and migraine, particularly migraine with aura, are each consistently associated with higher hazard of coronary bosom illness and ischemic changeable successful women according to anterior studies. The underlying biology liable for these risks mightiness besides summation the likelihood of gestation complications. But to date, lone a fewer tiny oregon retrospective studies person examined migraine arsenic a hazard origin for gestation complications. No prospective studies person examined risks by aura phenotype (migraine with versus without aura).

Purdue-Smithe and colleagues analyzed information from the large, prospective Nurses' Health Study II, which included 30,555 pregnancies from 19,694 U.S. nurses. Investigators looked astatine pre-pregnancy self-reported physician-diagnosed migraine and migraine phenotype (migraine with and without aura) and incidence of self-reported gestation outcomes.

Due to the ample size of the survey colonisation and availability of information connected different wellness and behavioral factors, researchers could power for imaginable confounding factors successful their analyses, specified arsenic assemblage wide index, chronic hypertension, and smoking.

Researchers recovered that pre-pregnancy migraine was associated with a 17 percent higher hazard of preterm delivery, 28 percent higher complaint of gestational hypertension, and 40 percent higher complaint of preeclampsia compared to nary migraine. Migraine with aura was associated with a somewhat higher hazard of preeclampsia than migraine without aura. Migraine was not associated with debased commencement value oregon gestational diabetes mellitus.

Participants with migraine who reported regular aspirin usage (more than doubly weekly) anterior to gestation had a 45 percent little hazard for preterm delivery. The US Preventive Services Task Force presently recommends low-dose aspirin during gestation for individuals astatine precocious hazard of preeclampsia and those who person much than 1 mean hazard origin for preeclampsia. Clinical trials person shown that low-dose aspirin during gestation is besides effectual astatine reducing rates of preterm birth. However, Purdue-Smithe notes that migraine is presently not included among indications for aspirin usage successful pregnancy. "Our findings of reduced hazard of preterm transportation among women with migraine who reported regular aspirin usage anterior to gestation suggests that aspirin whitethorn besides beryllium beneficial for women with migraine. Given the observational quality of our study, and the deficiency of elaborate accusation connected aspirin dosage disposable successful the cohort, objective trials volition beryllium needed to definitively reply this question."

Some different limitations of the survey see that, participants lone reported if they had a physician-diagnosis of migraine, apt excluding those who did not person chronic oregon terrible migraine. Further, aura was assessed aft the migraine diagnosis and aft galore of the pregnancies successful the cohort, perchance resulting successful immoderate grade of reverse causation successful analyses examining migraine phenotype. Additionally, the cohort survey consists of predominantly non-Hispanic achromatic individuals with comparatively precocious socioeconomic presumption and wellness literacy, which could bounds generalizability.