Are Pregnant Women With Migraine at Risk for Labor, Delivery Complications?

A new study revealed that pregnant women with severe migraine may be at increased risk for labor and delivery complications.

Scheduled to be presented at the American Academy of Neurology’s 68th Annual Meeting in April, the report’s findings suggest that acute migraine attacks in women are severe enough to result in complications when giving birth, including preterm delivery, preeclampsia, and low birth weight.

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The researchers from Montefiore Health System also found that women 35 and older were 7 times more likely to have these complications.

The investigators reviewed 5 years of data and identified 90 women with severe migraine who sought emergency care while pregnant. Their findings included:

• More than half of these women (54%) had at least one complication
• Nearly 30% of the women had a preterm delivery, compared to nearly 10% in the general population
• About 20% of the women with migraine had preeclampsia,compared to between 5 and 8% in the general population
• 19% of women with migraine delivered babies with low birth weight, compared to 8% in the general population

“The results of this study were of particular interest because more than half of the pregnant women with migraine experienced some type of adverse birth outcome, suggesting that these pregnancies should be considered high risk,” study author Matthew S. Robbins, MD, director of inpatient services at Montefiore Headache Center, chief of neurology at Jack D. Weiler Hospital of Montefiore, and associate professor of clinical neurology at Albert Einstein College of Medicine, said in a statement.

The majority of women with migraine in the study were treated with a combination of pill and intravenous (IV) drugs (62%). Out of the group, 76% took acetaminophen, while 54% were given IV metoclopramide and 54% were given IV diphenhydramine. The researchers are unsure of how the medications were related to the outcomes in this study.

“These findings need to be replicated with a larger number of women, including those who have migraine that does not manifest with severe attacks during pregnancy,” he said.

Reference

Robbins M, Grossman T, Govindappagari S, Dayal A. Delivery Outcomes After Acute Migraine Treatment in Pregnancy. Presented at: AAN Annual Meeting 2016. April 15-21, 2016; Vancouver, BC, Canada.