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

METHODS:

• Prospective, multicenter cohort study
  • Data derived from Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b)
  • Pregnant women followed prospectively through delivery
• Participants
  • Nulliparous, singleton pregnancies
• Exposures
  • History of migraines, as assessed by questionnaire
• Study design
  • 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
• Primary outcome
  • 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

RESULTS:

• 9450 participants
  • 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
  • Stillbirth
• Sensitivity analyses showed a larger effect in participants who reported recent migraine medication use
  • aOR 1.49 (95% CI, 1.18 to 1.88)

CONCLUSION:

• 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

Learn More – Primary Sources:

Migraine and adverse pregnancy outcomes: the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be

Related ObG Topics:

Antenatal Migraine, Preeclampsia and Risk for Maternal Stroke

What are the Consequences of Taking Triptan for Migraine During Pregnancy?

The New Migraine Medication: Is Rimegepant Effective?

Cochrane Review: What is the Evidence for the Prevention of Migraines Using Botulinum toxins?