Are Migraines a Risk Factor for Adverse Pregnancy Outcomes?
BACKGROUND AND PURPOSE:
Miller et al. (AJOG, 2022) assessed whether self-reported migraine in nulliparous individuals is associated with higher odds of a suite of adverse pregnancy outcomes
Prospective, multicenter cohort study
Data derived from Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b)
Pregnant women followed prospectively through delivery
Nulliparous, singleton pregnancies
History of migraines, as assessed by questionnaire
Logistic regression models used to estimate odds ratio (OR) and 95% CI for the association of migraine with adverse pregnancy outcomes (APO)
Adjusted for demographic characteristics
Sensitivity analyses were also performed
APO, defined as ≥1 of the following outcomes
Gestational hypertension | Preeclampsia or eclampsia | Preterm birth (medically indicated or spontaneous) | Small for gestational age at birth | Stillbirth
History of migraine: 19.1% of participants
Exposure groups did not differ for the following
Age | Income level | BMI
Migraine was associated with higher proportions of
Self-identified White race | Recent smoking history | Autoimmune disorders | Chronic kidney disease
Participants with migraine had increased odds of any APO
aOR 1.26 (95% CI, 1.12 to 1.41)
For individual adverse outcomes, participants with migraine had higher odds of
Any hypertensive disorders of pregnancy
Medically indicated and spontaneous preterm birth
Migraine was not associated with
Small for gestational age
Sensitivity analyses showed a larger effect in participants who reported recent migraine medication use
aOR 1.49 (95% CI, 1.18 to 1.88)
A history of migraine was associated with a higher risk of any adverse pregnancy outcome
The authors state
In a diverse, prospective cohort of 9450 nulliparous US participants, self-reported migraine headaches were associated with 26% higher odds of APO—an effect driven by HDP and both medically indicated and spontaneous PTB
Migraine may be an underrecognized risk factor for APO
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