Migraine and adverse pregnancy outcomes linked, The nuMoM2b study

Self-reported migraine headaches were associated with 26% higher odds of Adverse Pregnancy Outcomes (APO), an effect driven by hypertensive disorders of pregnancy (HDP), and both medically-indicated and spontaneous Pre-Term Birth (PTB), according to the latest research published in AJOG.

Migraine affects 28% of women in their pregnancy-capable years, and is associated with systemic inflammation, endothelial dysfunction, and increased risk of pregnancy-associated thromboembolic events.

"APO" may be defined as ≥1 of the following outcomes, gestational hypertension, preeclampsia/eclampsia, PTB (medically indicated or spontaneous), small-for-gestational-age at birth, or stillbirth.

Migraine history has been associated with adverse pregnancy outcomes (APO) of placental origin, including hypertensive disorders of pregnancy (HDP) and preterm birth

The authors, Eliza C. MILLER et. al tested the hypothesis that self-reported migraine in nulliparous individuals is associated with higher odds of APO.

The multi-center Nulliparous Pregnancy Outcomes Study Monitoring Mothers study enrolled 10,038 nulliparous US participants with singleton gestation in

early pregnancy, following them prospectively through delivery.

Medical histories were collected from study participants by the standardized interview: participants were asked "Have you ever had any of the following medical conditions or diagnoses?" followed by a list of diagnoses, which included "migraine headaches."

The researchers considered participants who responded "yes" to this question at the first-trimester study visit to have a migraine history.

They compared characteristics between participants who did and did not report migraine, including demographics, family history of preeclampsia, and comorbidities such as obesity, recent smoking, chronic hypertension, chronic kidney disease, pre-gestational diabetes, and autoimmune disorders.

Of 9,450 participants with complete data included in the analysis, 1,752 (19.1%) reported a diagnosis of migraine at the visit. Adjusting for all factors , participants with migraine had increased odds of any APO 

For individual APO, participants with migraine had higher odds of any Hypertensive Disorders of Pregnancy, and both medically indicated and spontaneous pre term birth, but not small-for-gestational-age or stillbirth.

There were no significant interactions between migraine and obesity, chronic hypertension or diabetes. Sensitivity analyses showed a larger effect in participants who reported recent medication use.