Migraine in pregnancy and lactation: a clinical review

MacGregor, Anne

doi:10.1783/147118907780254312

Cited by 26 publications

(15 citation statements)

References 67 publications

(68 reference statements)

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“…However, there is general consensus that migraine symptoms are normally relieved in the second and third trimesters (34,35), and such improvements refer to hormone/ opioid production from the placenta (36). Although such a result could be usefully exploited in clinical practice as a predictor of the onset of hypertension in pregnancy, these data have to be interpreted cautiously because of their retrospective collection.…”

Section: Discussionmentioning

confidence: 99%

Migraine is a Risk Factor for Hypertensive Disorders in Pregnancy: A Prospective Cohort Study

Facchinetti¹,

et al. 2009

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The aim was to assess whether women suffering from migraine are at higher risk of developing hypertensive disorders in pregnancy. In a prospective cohort study, performed at antenatal clinics in three maternity units in Northern Italy, 702 normotensive women with singleton pregnancy at 11-16 weeks' gestation were enrolled. Women with a history of hypertensive disorders in pregnancy or presenting chronic hypertension were excluded. The presence of migraine was investigated according to International Headache Society criteria. The main outcome measure was the onset of hypertension in pregnancy, defined as the occurrence of either gestational hypertension or preeclampsia. Two hundred and seventy women (38.5%) were diagnosed with migraine. The majority (68.1%) suffered from migraine without aura. The risk of developing hypertensive disorders in pregnancy was higher in migraineurs (9.1%) compared with non-migraineurs (3.1%) [odds ratio (OR) adjusted for age, family history of hypertension and smoking 2.85, 95% confidence interval (CI) 1.40, 5.81]. Women with migraine also showed a trend to increased risk for low birth weight infants with respect to women without migraine (OR 1.97, 95% CI 0.98, 3.98). Women with migraine are to be considered at increased risk of developing hypertensive disorders in pregnancy. The diagnosis of primary headaches should be taken into account at antenatal examination.

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Section: Discussionmentioning

confidence: 99%

Migraine is a Risk Factor for Hypertensive Disorders in Pregnancy: A Prospective Cohort Study

Facchinetti¹,

et al. 2009

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“…There are also few data on the risk related to their use during pregnancy, delivery and breast-feeding. Available recommendations come from the Regulatory Agencies of the single countries [376, 377]. …”

Section: Headache Management In Pregnancy and Lactationmentioning

confidence: 99%

Italian guidelines for primary headaches: 2012 revised version

et al. 2012

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The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version.

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“…This is the first epidemiological study of migraines occurring during pregnancy and the postpartum period in Asian, not only Japanese, patients. Several studies have prospectively investigated the course of migraines during these clinical situations (7,9,14,15). However, there has been no prospective investigation focusing on the course of migraines during the postpartum period.…”

Section: Discussionmentioning

confidence: 99%

Postpartum Migraines: A Long-term Prospective Study

et al. 2012

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Objective There are many reports regarding the course of migraines during pregnancy. However, the prevalence and characteristics of migraines during the postpartum period have not been adequately investigated. We prospectively investigated the patients suffering from migraines over a long postpartum period in an obstetrics department in Japan. Methods We investigated the course of migraines experienced during the postpartum period by patients in a postnatal ward. The patients were surveyed during the first postpartum week and 1, 3, 6 and 12 months after delivery. The patients were provided a headache diary to assess medication use and migraine attack frequency, severity (the faces pain scale) and duration. Results The migraine remission rate was 63%, 83% and 85% during the first, second and third trimesters, respectively. No patient experienced a worsening of headaches during pregnancy. Headache recurrence during the first month after delivery was more frequent in the patients >30 years of age than in those ! 30 years of age (p<0.05). The percentage of women experiencing recurrence at 1, 3, 6 and 12 months after delivery was 63%, 75%, 78% (n=60) and 87.5% (n=40), respectively. In breastfeeding patients, the rates were 50%, 65.8%, 71.1% and 91.7% and in bottle feeding patients, the rates were 86.4%, 90.9%, 95.5% and 81.3%, respectively. Conclusion We found that 85% of the patients with migraines experience remission during pregnancy and that more than 50% experience recurrence during the first month after delivery. Until six months after delivery, breastfeeding is associated with a lower recurrence rate than bottle feeding.

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Migraine in pregnancy and lactation: a clinical review

Cited by 26 publications

References 67 publications

Migraine is a Risk Factor for Hypertensive Disorders in Pregnancy: A Prospective Cohort Study

Migraine is a Risk Factor for Hypertensive Disorders in Pregnancy: A Prospective Cohort Study

Italian guidelines for primary headaches: 2012 revised version

Postpartum Migraines: A Long-term Prospective Study

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