Headaches after childbirth

Stein, George; Morton, John; Marsh, Andrew; Collins, William P.; Branch, Christine; Desaga, U; Ebeling, J.

doi:10.1111/j.1600-0404.1984.tb07782.x

Cited by 77 publications

(33 citation statements)

References 18 publications

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“…5 Thirty-nine percent of women are reported to have headache in the postpartum period. 6 For those who have received a regional block with either apparent or possible accidental dural puncture, a postural headache is invariably considered to be the result of dural puncture. With a growing number of women now receiving epidural analgesia during labour, there is an increase in the number of accidental dural punctures.…”

Section: Discussionmentioning

confidence: 99%

Cerebral venous sinus thrombosis following accidental dural puncture and epidural blood patch

Ghatge

Uppugonduri

Kamarzaman

2008

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Cerebral venous sinus thrombosis following accidental dural puncture and epidural blood patch

Ghatge

Uppugonduri

Kamarzaman

2008

International Journal of Obstetric Anesthesia

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“…Postpartum headache is common, occurring in about 30–40% of all women, not only migraineurs [10, 11, 25]. In general, headaches after birth are strongly associated with the presence of a previous or family history of migraine [25, 26].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2011

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There is little prospectively gathered data on the course of headaches during pregnancy and postpartum, and the influence of breastfeeding is unclear. This is a large, prospective study, which invited all pregnant women in the catchment area during a defined period. All participants (n = 2,126) filled in questionnaires concerning headache. Among these, a total of 208 women with migraine according to the International Headache Society criteria also filled in detailed headache diaries during pregnancy and the puerperal period. Freedom from earlier headaches during pregnancy was significantly more common than new onset of headache during pregnancy (p < 0.001). This was not influenced by prior use of oral contraceptives. According to the diaries, there was a gradual decrease during pregnancy in the frequency of all headaches and of self-considered migraine. There was also a significant decrease in the duration of headaches (p < 0.001) during pregnancy compared to before. Earlier parity did not influence the course. Apart from a significant increase during the first week postpartum (p < 0.01), the overall occurrence of headaches during puerperium did not differ from the pregnancy period. Compared to pregnancy, there was a postpartum increase in the mean intensity (p < 0.01) and duration (p = 0.050) of headaches, as well as in the mean number of analgesics used (p < 0.001). Breastfeeding did not influence the occurrence of headaches postpartum. These data are of practical value for informing pregnant migraineurs about the typical clinical prospects and for giving advice on breastfeeding.

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“…Limited cross-sectional data have implicated previous headache history, dural puncture, multiparity, and increasing age as risk factors associated with headache in the postpartum period. 7, 12, 18 …”

Section: Discussionmentioning

confidence: 99%

Predictors of Headache Before, During, and After Pregnancy: A Cohort Study

et al. 2012

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Objective The present study endeavored to identify predictors of headache during pregnancy, shortly after delivery, and at 8-week follow-up. Background Many women suffer from headaches during pregnancy and the postpartum period. However, little is known about factors that predict headache surrounding childbirth. Methods Secondary analysis of longitudinal cohort study of 2434 parturients hospitalized for cesarean or vaginal delivery in four university hospitals in the United States and Europe. Data were gathered from interviews and review of medical records shortly after delivery; 972 of the women were contacted 8 weeks later to assess persistent headache. The primary outcome measures were experiencing headache during pregnancy, headache within 72 hours after delivery, and headache at 8 weeks after delivery. Results Of the parturients, 10% experienced headache during pregnancy, 3.7% within 72 hours after delivery, and 3.6% at 8 weeks post delivery. Compared to those without a history of headache, a history of headache prior to pregnancy was the strongest predictor of headache during pregnancy (9.8% versus 23.5%; RR 2.4; 95% CI: 1.4 to 4.0). Experiencing headache during pregnancy (adjusted HR 3.8; 95% CI: 2.4 to 6.2) and receiving needle-based regional anesthesia for pain treatment (adjusted HR 2.2; 95% CI: 1.1 to 4.5) were independently associated with headache within 72 hours after delivery with event rates of 11.1% and 10.5%, respectively. Compared to those without such a history, headache before pregnancy was significantly associated with experiencing headache 8 weeks after delivery (4.0% versus 23.8%; RR = 6.0; 95% CI: 2.0 to 8.0), but headache during pregnancy or shortly after delivery was not. Several other psychosocial predictors (e.g., somatization, smoking before pregnancy) were statistically associated with at least one headache outcome. Conclusions A history of headache prior to pregnancy is a strong predictor of headache during and after pregnancy, the latter independent of but compounded by spinal injection. Physicians should attend to prior headache history when making decisions about pain management during and after childbirth. As the lack of formal ICHD-II headache diagnoses is a limitation of this study, future longitudinal studies should replicate the present design while including headache subtyping consistent with ICHD-II nosology.

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Headaches after childbirth

Cited by 77 publications

References 18 publications

Cerebral venous sinus thrombosis following accidental dural puncture and epidural blood patch

Cerebral venous sinus thrombosis following accidental dural puncture and epidural blood patch

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

Predictors of Headache Before, During, and After Pregnancy: A Cohort Study

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