Could Migraines Raise Odds for Complications in Pregnancy?

Women who suffer from migraines may have a higher risk of preeclampsia and other pregnancy complications, a new study suggests. Black women have the highest age-adjusted prevalence of preeclampsia (12.4%) compared with Hispanic (8.2%) and white women (7.1%), according to John Hopkins Medicine.

The researchers looked at more than 30,000 pregnancies in about 19,000 women over a 20-year period.

"Roughly 20% of women of childbearing age experience migraine, but the impact of migraine on pregnancy outcomes has not been well understood," says study author Alexandra Purdue-Smithe. She is an associate epidemiologist at Brigham and Women's Hospital in Boston.

"Our large prospective study found links between migraine and pregnancy complications that could help inform doctors and women with migraine of potential risks they should be aware of," Purdue-Smithe said in a news release from the American Academy of Neurology.

What the study shows

For the study, her team assessed rates of complications such as preterm delivery, gestational diabetes and high blood pressure, low birth weight and preeclampsia, a complication marked by high blood pressure and signs of damage to other organ systems. It threatens the life of both mother and baby.

After adjusting for age, obesity and other factors that could affect the risk of pregnancy complications, the researchers found that women with migraine had a 17% higher risk of preterm delivery, a 28% higher risk of gestational high blood pressure and a 40% higher risk of preeclampsia than women without migraine.

Among migraine sufferers, 10% had preterm delivery, 7% had gestational high blood pressure and 6% had preeclampsia. Rates were 8%, 5% and 3%, respectively, among women without migraine, the investigators found.

The risk of preeclampsia was much higher among women who had migraine with aura, in which visual disturbances (such as flashing lights) occur before the headache, according to the report. Preeclampsia risk was 51% higher among women who had migraine with aura and 29% higher among those who had migraine without aura than among women without migraine.

However, the associations found in the study do not prove a cause-and-effect relationship. In addition, migraine was not associated with gestational diabetes or low birth weight, the study authors said.

The researchers are scheduled to present the study findings at an American Academy of Neurology meeting, held April 2 to 7 in Seattle and online April 24 to 26. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

"While the risks of these complications are still quite low overall, women with a history of migraine should be aware of and consult with their doctor on potential pregnancy risks," Purdue-Smithe said.

"More research is needed to determine exactly why migraine may be associated with higher risks of complications," she adds. "In the meantime, women with migraine may benefit from closer monitoring during pregnancy so that complications like preeclampsia can be identified and managed as soon as possible."

Migraines: Why Do They Start & How to End Them

Pregnancy and migraine treatment

Doctors typically advise against pregnant women using medications. However, two-thirds of women take medications during pregnancy, and 50% take them during the first trimester, according to the American Migraine Foundation. If you are pregnant or plan to become pregnant, you should closely weigh your treatment options. Here’s what some experts recommend:

Identify and avoid your triggers. Experiment by avoiding foods like chocolate, caffeine, and processed foods, to see if it affects your migraines.
Make sleep a priority. Follow consistent sleep and wake times. Purchase and practice using earplugs and a sleep mask, if necessary. Use good sleep hygiene.
Stay hydrated. If you’ve ever gone to the emergency room with a migraine, you’ll remember that the first thing they do is to administer intravenous saline to combat dehydration. Your body needs far more water when you’re pregnant. Keep drinking, and consider incorporating electrolyte-rich supplementary fluids like Pedialyte.
Have a treatment plan—and a backup plan. What medications work for you, and when and how do you take them? What non-pharmaceutical treatments offer you relief? It’s good to become familiar with and discuss pain plans and pain medications with both doctors before you need them.

For more information on taking medication while pregnant, check out the FDA’s safety guide. Before you finalize your treatment plan, remember to consult with your doctor. Your physician can help you determine the best course of action for you and your child.