Pregnant women with acute migraine more likely to experience adverse birth outcomes

Women who have acute migraine attacks that are severe enough to prompt them to seek care may be more likely to have complications when giving birth, including preterm delivery, preeclampsia and low birthweight. Women 35 and older were seven times more likely to have these complications.

These findings, conducted by researchers at Montefiore Health System, will be presented at the American Academy of Neurology's 68th Annual Meeting on April 15 to 21.

"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," said study author Matthew S. Robbins, M.D., 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. "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."

Acute migraine attacks are disabling headaches with symptoms that may include light and sound sensitivity, nausea, vomiting and visual disturbances.

Researchers reviewed five years of data at Montefiore and identified 90 women with severe migraine who sought emergency care while pregnant. The findings included:
•More than half of these women (54 percent) had at least one complication.
•Nearly 30 percent of the women had a preterm delivery, compared to nearly 10 percent in the general population.
•About 20 percent of the women with migraine had preeclampsia, a condition marked by high blood pressure, compared to between 5 and 8 percent in the general population.
•19 percent of the women with migraine delivered babies with low birthweight, compared to 8 percent in the general population.

Most of the women with migraine, 62 percent, were treated with a combination of pill and intravenous (IV) drugs. Of those, 76 percent took acetaminophen, while 54 percent were given IV metoclopramide, a drug also prescribed for nausea, and 54 percent were given IV diphenhydramine, an antihistamine. It is not certain how the medications related to the outcomes in this study.