The migraine syndrome in pregnancy

Callaghan, N.

doi:10.1212/wnl.18.2.197

Cited by 83 publications

(52 citation statements)

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“…Most data available on the course of migraine during pregnancy are retrospective, the patients having been evaluated several years after pregnancy or, at best, in the postpartum period [7,[16][17][18][19][20][21][22]. In these studies, the percentage of women with migraine showing an improvement during pregnancy varies broadly, from 43% [20] to 86% [21].…”

Section: Course Of Migraine During Pregnancymentioning

confidence: 99%

Headaches During Pregnancy

Nappi

Albani

Sances

et al. 2011

Curr Pain Headache Rep

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Among primary headaches, migraine is the form more sensitive to the ovarian hormonal milieu. Migraine without aura (MO) benefits from the hyperestrogenic state of pregnancy and the lack of hormonal fluctuations, while migraine with aura (MA) presents distinctive features. Indeed, a very strong improvement of MO has been documented across gestation, and only a minority of pregnant women still suffers during the third trimester. On the other hand, fewer women with MA report improvement or remission, and new onset of aura may be observed during pregnancy. After delivery, breastfeeding exerts a protective action on migraine recurrence. The persistence of migraine during gestation seems to affect neonatal outcomes, and several studies indicate a link between migraine and an increased risk of developing gestational hypertension/preeclampsia and other vascular complications.

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Section: Course Of Migraine During Pregnancymentioning

confidence: 99%

Headaches During Pregnancy

Nappi

Albani

Sances

et al. 2011

Curr Pain Headache Rep

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“…In addition, many women with migraine have fewer attacks during pregnancy [Callaghann, 1968;Nattero, 1982;Somerville, 1972], although the condition may be exacerbated in the postpartum period [Stein, 1981]. Also, some women have fewer attacks or cease to have attacks after menopause [Martin et al, 1971].…”

Section: Genetic Influence and Sex-limitationmentioning

confidence: 99%

Latent class and genetic analysis does not support migraine with aura and migraine without aura as separate entities

Nyholt

Gillespie

Heath

et al. 2004

Genetic Epidemiology

115

121

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Latent class and genetic analyses were used to identify subgroups of migraine sufferers in a community sample of 6,265 Australian twins (55% female) aged 25-36 who had completed an interview based on International Headache Society (IHS) criteria. Consistent with prevalence rates from other population-based studies, 703 (20%) female and 250 (9%) male twins satisfied the IHS criteria for migraine without aura (MO), and of these, 432 (13%) female and 166 (6%) male twins satisfied the criteria for migraine with aura (MA) as indicated by visual symptoms. Latent class analysis (LCA) of IHS symptoms identified three major symptomatic classes, representing 1) a mild form of recurrent nonmigrainous headache, 2) a moderately severe form of migraine, typically without visual aura symptoms (although 40% of individuals in this class were positive for aura), and 3) a severe form of migraine typically with visual aura symptoms (although 24% of individuals were negative for aura). Using the LCA classification, many more individuals were considered affected to some degree than when using IHS criteria (35% vs. 13%). Furthermore, genetic model fitting indicated a greater genetic contribution to migraine using the LCA classification (heritability, h(2)=0.40; 95% CI, 0.29-0.46) compared with the IHS classification (h(2)=0.36; 95% CI, 0.22-0.42). Exploratory latent class modeling, fitting up to 10 classes, did not identify classes corresponding to either the IHS MO or MA classification. Our data indicate the existence of a continuum of severity, with MA more severe but not etiologically distinct from MO. In searching for predisposing genes, we should therefore expect to find some genes that may underlie all major recurrent headache subtypes, with modifying genetic or environmental factors that may lead to differential expression of the liability for migraine.

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“…56 In contrast to these 2 studies, Callaghan reported a much higher percentage of women with migraines occurring for the first time in pregnancy and worse outcomes than the 2 previous studies. 57 Chen and Leviton retrospectively reviewed 55,000 pregnancies and found a 1.3% incidence of migraine, 58 a proportion that was lower than other studies. 59,60 Of the women reporting migraine headaches, 79% reported improvement.…”

Section: Pre-ihs Classificationmentioning

confidence: 86%

“…62 Thus, despite the use of standardized criteria for diagnosing migraine headaches, headache improvement during pregnancy ranges from 18% to 86%. [55][56][57][58][59][60][61][62][63][64][65][66][67] These studies have not identified consistent prognostic factors associated with headache improvement during pregnancy, although some have suggested that migraine with aura was less likely to improve than migraine without aura. 59,64,66,68 -70 However, when examining all of these data, it seems that the majority of women experienced either an improvement or no change in migraine frequency during pregnancy.…”

Section: Post-ihs Classificationmentioning

confidence: 99%

“…55,65 None of the published clinical studies have identified any specific differences between those with onset during pregnancy and those that report improvement, nor have they shown any causes or associated prognostic factors for this group. 55,57,65 Clearly, there are a number of controversial issues in the natural history of migraines during pregnancy. The ability to predict the course of migraine during pregnancy may not improve until there is a better understanding of the pathophysiology of migraine.…”

Section: Post-ihs Classificationmentioning

confidence: 99%

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Headache and Pregnancy

Menon

Bushnell

2008

The Neurologist

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Primary headache disorders, in particular TTHs and migraines, generally improve during pregnancy. However the frequency of improvement varies greatly. Because the pathophysiology of both migraines and TTHs is poorly understood, this limits our ability to predict improvement. Future research should be focused on headache pathophysiology and the effect of ovarian hormones and the pregnant state on headache pathogenesis.

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The migraine syndrome in pregnancy

Cited by 83 publications

References 0 publications

Headaches During Pregnancy

Headaches During Pregnancy

Latent class and genetic analysis does not support migraine with aura and migraine without aura as separate entities

Headache and Pregnancy

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