Headaches during pregnancy in women with a prior history of menstrual headaches

Abstract

-Objective: To evaluate the presence of menstrual headaches prior to pregnancy according to the International Headache Society (IHS) classification criteria, 2004, and also study the outcome (fre q u e ncy and intensity) of these pre-existing headaches during the gestational trimesters. Method: This study involved 1,101 pregnant women (12 to 45 years old). A semi-stru c t u red questionnaire was used to interview the women during the first, second and third gestational trimesters as well as after delivery. All the i n t e rviews were conducted by one of the re s e a rchers by applying the IHS Classification (IHSC-2004). R e s u l t s A 1,029 women out of the 1,101 women interviewed presented headaches prior to gestation, which made it possible to study headaches in 993 women during the gestational trimesters. Menstrually related headaches w e re presented by 360 of the 993 women. Migraine was re p o rted by 332/360 women (92.22%) with mens t rual headaches and 516/633 women (81.51%) without menstrual headaches, re s p e c t i v e l y, prior to gestation. The majority of the women with menstrual migraine presented a headache improvement or disappearance during gestation (62.22% during the first trimester; 74.17% during the second trimester; 77.78% during the third trimester). Conclusion: Most of the pregnant women with menstrual or non-menstrual headaches prior to gestation presented migraine, which either improved or disappeared during pre g n a ncy. Women who suffered from non-menstrual headaches improved during pregnancy but not as much as women with menstrual headaches.KEY WORDS: headache, pregnancy, menstrual, migraine. Apresentaram cefaléia re l a c i o n ada à menstruação 360/993 mulheres. Encontramos migrânea em, 332/360 (92,22%) mulheres com cefaléia menstrual e em 516/633 (81,51%) mulheres com cefaléia não menstrual antes da gestação. A maioria das m u l h e res com migrânea menstrual apresentou melhora da cefaléia durante a gestação (62,22% no primeiro t r i m e s t re; 74,17% no segundo trimestre; 77.78% no terc e i ro trimestre ) . Conclusão: A maioria das mulheres grávidas, com cefaléia tanto menstrual quanto não menstrual, antes da gestação, apresentou migrânea, sendo que a mesma melhora ou desaparece durante a gestação. Mulheres com cefaléia não menstru a l antes da gestação melhoram em proporção menor do que aquelas com cefaléia menstrual. Cefaléia durante a gestação em mulheres com história de cefaléia menstrual R E S U M O -

Migraine in women: the role of hormones and their impact on vascular diseases

“…1). Improvement is more likely in women with a history of MM [7, 30, 31]. If migraine does not improve by the end of the first trimester, it is likely to continue throughout the pregnancy [32].…”

Headache and migraine during pregnancy and puerperium: the MIGRA-study

“…Several studies have shown that about one-half to three-fourths of female migraineurs experience a reduction in the frequency or total cessation of migraine attacks during pregnancy [1–12], mainly in the second and third trimesters [5, 7, 11, 13, 14]. In addition, the average pain intensity of the remaining attacks decreases as the pregnancy proceeds [10].…”

“…If migraine is not improved by the end of the first trimester, it is likely to continue throughout the pregnancy and postpartum periods [15]. The improvement seems to be especially prominent in women with perimenstrual or pure menstrual migraine [1, 3, 4, 7, 9], and one study has shown that women having migraine without aura are more likely to become better than women having migraine with aura [2]. …”

Migraine in pregnancy and lactation: a clinical review

“…Respite is greater for women with a history of menstrual or menstrually related migraine without aura than for women with no evidence of a menstrual association. [8][9][10] Migraine with aura In contrast to migraine without aura, women who have preexisting migraine with aura are more likely to continue to have attacks during pregnancy. 9 Women with pre-existing migraine without aura may develop aura for the first time during pregnancy.…”

“…Olesen (1992) 66 Granella et al 67 Chen and Leviton (1994) 68 Cupini et al 69 Scharff et al 26 Maggioni et al 16 Marcus et al 7 Granella et al 9 Sances et al 8 Kelman (2004) 70 Melhado et al 10 Ertresvag et al Of all the parameters studied, the only positive finding was that limb deficiencies were associated with a higher rate of maternal migraines during the first trimester of pregnancy, for both the congenital abnormalities group vs matched normal group (adjusted POR 2.5, 95% CI 1.1-5.8) and the congenital abnormalities group vs Down syndrome controls (adjusted POR 1.7, 95% CI 1.3-3.0). Although this study has the benefit of large numbers, these data are not confirmatory and the effect of other independent variables, drug and non-drug treatments taken, and misdiagnosis of conditions mimicking migraine cannot be ruled out.…”