Prepregnancy Migraine, Migraine Phenotype, and Risk of Adverse Pregnancy Outcomes.
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
04 04 2023
04 04 2023
Historique:
received:
19
08
2022
accepted:
05
12
2022
medline:
5
4
2023
pubmed:
20
1
2023
entrez:
19
1
2023
Statut:
ppublish
Résumé
Migraine is a highly prevalent neurovascular disorder among reproductive-aged women. Whether migraine history and migraine phenotype might serve as clinically useful markers of obstetric risk is not clear. The primary objective of this study was to examine associations of prepregnancy migraine and migraine phenotype with risks of adverse pregnancy outcomes. We estimated associations of self-reported physician-diagnosed migraine and migraine phenotype with adverse pregnancy outcomes in the prospective Nurses' Health Study II (1989-2009). Log-binomial and log-Poisson models with generalized estimating equations were used to estimate relative risks (RRs) and 95% CIs for gestational diabetes mellitus (GDM), preeclampsia, gestational hypertension, preterm delivery, and low birthweight. The analysis included 30,555 incident pregnancies after cohort enrollment among 19,694 participants without a history of cardiovascular disease, diabetes, or cancer. After adjusting for age, adiposity, and other health and behavioral factors, prepregnancy migraine (11%) was associated with higher risks of preterm delivery (RR = 1.17; 95% CI = 1.05-1.30), gestational hypertension (RR = 1.28; 95% CI = 1.11-1.48), and preeclampsia (RR = 1.40; 95% CI = 1.19-1.65) compared with no migraine. Migraine was not associated with low birthweight (RR = 0.99; 95% CI = 0.85-1.16) or GDM (RR = 1.05; 95% CI = 0.91-1.22). Risk of preeclampsia was somewhat higher among participants with migraine with aura (RR vs no migraine = 1.51; 95% CI = 1.22-1.88) than migraine without aura (RR vs no migraine = 1.30; 95% CI = 1.04-1.61; Migraine history, and to a lesser extent migraine phenotype, appear to be important considerations in obstetric risk assessment and management. Future research should determine whether aspirin prophylaxis may be beneficial for preventing adverse pregnancy outcomes among pregnant individuals with a history of migraine.
Sections du résumé
BACKGROUND AND OBJECTIVE
Migraine is a highly prevalent neurovascular disorder among reproductive-aged women. Whether migraine history and migraine phenotype might serve as clinically useful markers of obstetric risk is not clear. The primary objective of this study was to examine associations of prepregnancy migraine and migraine phenotype with risks of adverse pregnancy outcomes.
METHODS
We estimated associations of self-reported physician-diagnosed migraine and migraine phenotype with adverse pregnancy outcomes in the prospective Nurses' Health Study II (1989-2009). Log-binomial and log-Poisson models with generalized estimating equations were used to estimate relative risks (RRs) and 95% CIs for gestational diabetes mellitus (GDM), preeclampsia, gestational hypertension, preterm delivery, and low birthweight.
RESULTS
The analysis included 30,555 incident pregnancies after cohort enrollment among 19,694 participants without a history of cardiovascular disease, diabetes, or cancer. After adjusting for age, adiposity, and other health and behavioral factors, prepregnancy migraine (11%) was associated with higher risks of preterm delivery (RR = 1.17; 95% CI = 1.05-1.30), gestational hypertension (RR = 1.28; 95% CI = 1.11-1.48), and preeclampsia (RR = 1.40; 95% CI = 1.19-1.65) compared with no migraine. Migraine was not associated with low birthweight (RR = 0.99; 95% CI = 0.85-1.16) or GDM (RR = 1.05; 95% CI = 0.91-1.22). Risk of preeclampsia was somewhat higher among participants with migraine with aura (RR vs no migraine = 1.51; 95% CI = 1.22-1.88) than migraine without aura (RR vs no migraine = 1.30; 95% CI = 1.04-1.61;
DISCUSSION
Migraine history, and to a lesser extent migraine phenotype, appear to be important considerations in obstetric risk assessment and management. Future research should determine whether aspirin prophylaxis may be beneficial for preventing adverse pregnancy outcomes among pregnant individuals with a history of migraine.
Identifiants
pubmed: 36657989
pii: WNL.0000000000206831
doi: 10.1212/WNL.0000000000206831
pmc: PMC10104618
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1464-e1473Subventions
Organisme : NHLBI NIH HHS
ID : K01 HL159281
Pays : United States
Organisme : NINDS NIH HHS
ID : K08 NS124991
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL145386
Pays : United States
Organisme : NCI NIH HHS
ID : U01 CA176726
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023 American Academy of Neurology.
Références
Cephalalgia. 2018 Jan;38(1):1-211
pubmed: 29368949
Am J Epidemiol. 1991 Nov 15;134(10):1111-20
pubmed: 1746521
J Reprod Immunol. 2003 Jun;59(1):29-37
pubmed: 12892901
Int J Epidemiol. 1994 Oct;23(5):991-9
pubmed: 7860180
JAMA. 2021 Sep 28;326(12):1192-1206
pubmed: 34581730
Headache. 2019 Jun;59(6):869-879
pubmed: 31069791
Epidemiology. 1992 Jan;3(1):53-6
pubmed: 1554810
Clin Exp Hypertens. 2010 May;32(3):159-65
pubmed: 20504123
Am J Obstet Gynecol. 2022 Sep;227(3):535-536
pubmed: 35504328
N Engl J Med. 1998 Jan 15;338(3):147-52
pubmed: 9428815
Hypertension. 2020 Mar;75(3):772-780
pubmed: 32008433
Cephalalgia. 2009 Mar;29(3):286-92
pubmed: 19220309
J Perinatol. 2011 Jun;31(6):434-9
pubmed: 21183924
Headache. 2011 Nov-Dec;51(10):1468-82
pubmed: 21797858
Neurology. 2005 Mar 22;64(6):1020-6
pubmed: 15781820
JAMA. 2001 Mar 28;285(12):1607-12
pubmed: 11268269
Eur J Obstet Gynecol Reprod Biol. 2012 Apr;161(2):140-3
pubmed: 22280825
Am J Epidemiol. 2014 Aug 15;180(4):346-58
pubmed: 24989239
BMC Womens Health. 2010 Oct 26;10:30
pubmed: 20977769
Paediatr Perinat Epidemiol. 2011 Mar;25(2):116-23
pubmed: 21281324
Eur J Obstet Gynecol Reprod Biol. 2005 Aug 1;121(2):143-8
pubmed: 16054953
Headache. 2015 Jan;55(1):21-34
pubmed: 25600719
Curr Opin Neurol. 2015 Jun;28(3):255-60
pubmed: 25923125
J Headache Pain. 2020 Aug 6;21(1):97
pubmed: 32762643
Eur J Obstet Gynecol Reprod Biol. 2007 Oct;134(2):157-63
pubmed: 17097212
Cephalalgia. 2011 Oct;31(14):1459-65
pubmed: 21926156
Cephalalgia. 2010 Apr;30(4):433-8
pubmed: 19614685
Thromb Res. 2007;119(2):217-22
pubmed: 16504253
Am J Obstet Gynecol. 2020 Nov;223(5):741.e1-741.e12
pubmed: 32434001
Int J Epidemiol. 1996 Feb;25(1):122-7
pubmed: 8666479
Int J Epidemiol. 1995 Jun;24(3):612-8
pubmed: 7672904
J Headache Pain. 2020 Jun 5;21(1):67
pubmed: 32503410
Int J Epidemiol. 1989 Dec;18(4):858-67
pubmed: 2621022
Cephalalgia. 2009 Oct;29(10):1086-90
pubmed: 19735535
J Pregnancy. 2012;2012:858097
pubmed: 22934185
Am J Epidemiol. 1985 Jul;122(1):51-65
pubmed: 4014201
Clin Sci (Lond). 2016 Mar;130(6):409-19
pubmed: 26846579
Ethn Dis. 2016 Jul 21;26(3):323-30
pubmed: 27440971
Ann Intern Med. 2018 Aug 21;169(4):224-232
pubmed: 29971437
JAMA. 2020 Jun 9;323(22):2281-2289
pubmed: 32515815
Cephalalgia. 2018 Mar;38(3):511-518
pubmed: 28885052
Stroke. 2009 Sep;40(9):2977-82
pubmed: 19608996
Am J Epidemiol. 1992 May 15;135(10):1114-26; discussion 1127-36
pubmed: 1632423
Front Immunol. 2015 Nov 16;6:566
pubmed: 26635788
Circulation. 2017 Feb 7;135(6):578-589
pubmed: 28153993
Diabetes Care. 1996 Jan;19(1):12-6
pubmed: 8720526
Am J Hypertens. 2008 Mar;21(3):360-4
pubmed: 18202669
J Neurol Neurosurg Psychiatry. 2004 Jul;75(7):984-7
pubmed: 15201354
Am J Epidemiol. 2005 Dec 1;162(11):1108-13
pubmed: 16236995
J Matern Fetal Neonatal Med. 2005 Sep;18(3):167-72
pubmed: 16272039