Migraine Headaches and Preeclampsia: An Epidemiologic Review

Abstract

Available evidence suggests that migraines and preeclampsia may reflect an underlying predisposition toward ischemic injury. More rigorous epidemiologic research is warranted, after consideration of several important methodologic issues.

Course of migraine during pregnancy among migraine sufferers before pregnancy

“…Another possible explanation for this association, especially in the third trimester, would be the fact that in both, migraine and preeclampsia cases, there are altered vasoreactivity and abnormal platelet behaviour 23,24 , with a higher prevalence of headaches among women with preeclampsia, and in particular, of migraine 24,25 . However, as the diagnosis were retrospective in the present study, one could not specify which type of hypertension the women had, if preeclampsia or hypertension prior to pregnancy.…”

Investigation of endothelin-1 type A receptor gene polymorphism (−231 G > A) in preeclampsia susceptibility

“…Plasma ET-1 levels have in fact been found to be markedly elevated at the beginning of the migraine attack and declined in the course of an attack thus suggesting that ET-1 is involved in the hemodynamic changes and vascular tone modifications observed during migraine attacks [24]. Additionally, evidence from many epidemiological studies has been collected supporting an underlying predisposition toward ischemic injury for migraines and preeclampsia [25], making it reasonable to hypothesize that they share common underlying genetic variants, such as the 7231 G 4 A EDNRA polymorphism. Furthermore, the above-mentioned polymorphism has been shown to be associated with both systolic and diastolic blood pressure in female hypertensives [20].…”

Headache and Pregnancy

“…The pathophysiology of both conditions is poorly understood but both are characterized by abnormal vasoreactivity, endothelial dysfunction, and platelet behavior. 73,74,77 The studies to date do not confirm that a history of migraines, although it may increase the risk of preeclampsia, does not necessarily translate into a higher risk of poor pregnancy outcomes. Therefore, further studies are needed to fully evaluate the relationship between migraine and preeclampsia and the effect this has on pregnancy outcomes in pregnant migraineurs.…”

“…Although the mechanisms are not fully understood, there seems to be an association between a history of migraine and an increased risk of preeclampsia during pregnancy. [73][74][75][76] Various features of headaches have been associated with preeclampsia/eclampsia, such as worsening headache during pregnancy. 75 In a case-control study, women diagnosed with preeclampsia were more likely to have had a previous history of headaches when compared with controls (54% in preeclamptic women vs. 17% in uncomplicated pregnancies).…”