Pregnant Women With Severe Migraine Should Be Considered High Risk

MedicalResearch.com Interview with:

Matthew S. Robbins, MD, FAHS Associate Professor of Clinical Neurology, Albert Einstein College of Medicine Chief of Neurology, Jack D. Weiler Hospital, Montefiore Medical Center Director of Inpatient Services, Montefiore Headache Center Associate Program Director, Neurology Residency

Dr. Matthew Robbins

Matthew S. Robbins, MD, FAHS
Associate Professor of Clinical Neurology, Albert Einstein College of Medicine
Chief of Neurology, Jack D. Weiler Hospital
Montefiore Medical Center
Director of Inpatient Services, Montefiore Headache Center
Associate Program Director, Neurology Residency

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Robbins: It is now well-established that having a history of migraine increases the risk of having vascular and obstetrical complications for pregnant women.  What is not known is if having active migraine during pregnancy would increase complications later on in that very same pregnancy.  Having severe migraine attacks during pregnancy may indicate particularly severe and active disease.  We evaluated pregnant women who presented to the hospital setting with acute, severe migraine attacks, and then reviewed their records for what happened during the same pregnancy when they delivered.  We found that compared to local and national rates, pregnant women with severe migraine attacks presenting to the hospital have increased rates of preeclampsia, preterm delivery, and low birthweight.  This risk was particularly elevated in pregnant women age 35 years or older.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Robbins: More than half of patients experienced some type of adverse birth outcome. This finding suggests that pregnancies in such women should be considered high risk, especially in older women.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Robbins: Our study did not include a control group of pregnant women with migraine who did not present to acute care during the same pregnancy,, so future studies should compare obstetrical outcomes in such patients with a lesser degree of migraine severity. We also would like to see if our results generalize to pregnant women outside of the Bronx, NY and to see what the impact of prenatal care, including high risk prenatal care with a maternal fetal medicine specialist, may be. 

MedicalResearch.com: Is there anything else you would like to add?

Dr. Robbins: Migraine needs to be recognized as a brain disease that is associated with many implications well outside of headache, including relationships with cardiovascular and obstetrical health.  The presence of migraine should impact management by obstetricians and practitioners such as neurologists who take care of patients with headache. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Abstract to be presented at the 2016 American Academy of Neurology’s 68th Annual Meeting on April 2016

Pregnant Women With Severe Migraine May Be At Increased Risk For Labor And Delivery Complications

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Matthew S. Robbins, MD, FAHS (2016). Pregnant Women With Severe Migraine Should Be Considered High Risk