Pre-pregnancy migraine diagnosis, medication use, and spontaneous abortion: a prospective cohort study

The Journal of Headache and Pain

Research

Henrik T. Sørensen¹  Ellen M. Mikkelsen¹  Lauren A. Wise²  Susan S. Jick²  Elizabeth E. Hatch²  Kenneth J. Rothman²  Amelia K. Wesselink²  Holly M. Crowe³ 

[1] Aarhus University, Department of Clinical Epidemiology, Olof Palmes Allé 43-45, DK-8200, Aarhus N, Denmark;Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, 02118, Boston, MA, USA;Harvard T.H. Chan School of Public Health, Department of Epidemiology, 677 Huntington Avenue, 02115, Boston, MA, USA;Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, 02118, Boston, MA, USA;

关键词: Migraine;    Triptans;    Epidemiology;    Pregnancy;    Spontaneous abortion;    Miscarriage;   

DOI  :  10.1186/s10194-022-01533-6

 received in 2022-08-31, accepted in 2022-12-08,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundMigraine is common among females of reproductive age (estimated prevalence:17–24%) and may be associated with reproductive health through underlying central nervous system excitability, autoimmune conditions, and autonomic dysfunction. We evaluated the extent to which pre-pregnancy migraine diagnosis and medication use are associated with risk of spontaneous abortion (SAB).MethodsWe analyzed data from a preconception study of pregnancy planners (2013–2021). Eligible participants self-identified as female, were aged 21–45 years, resided in the USA or Canada, and conceived during follow-up (n = 7890). Participants completed baseline and bimonthly follow-up questionnaires for up to 12 months or until a reported pregnancy, whichever occurred first. Pregnant participants then completed questionnaires during early (~ 8–9 weeks) and late (~ 32 weeks) gestation. We defined migraineurs as participants who reported a migraine diagnosis or use of a medication to treat migraine. Preconception questionnaires elicited migraine medication use during the past 4 weeks, and SAB on follow-up and pregnancy questionnaires. We used Cox regression models with gestational weeks as the time scale to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations among preconception migraine, migraine medication use, and SAB, controlling for potential demographic, medical, and lifestyle confounders.ResultsNineteen percent of study pregnancies ended in SAB. History of migraine before conception was not appreciably associated with SAB risk (HR = 1.03, 95% CI: 0.91–1.06). Use of any migraine medication was associated with a modest increase in SAB risk overall (HR = 1.14, 95% CI: 0.96–1.36). We observed the greatest increase in risk among those taking migraine medications daily (HR = 1.38, 95% CI: 0.81–2.35) and those taking prescription migraine prophylaxis (HR = 1.43, 95% CI: 0.72–2.84) or combination analgesic and caffeine medications (HR = 1.42, 95% CI: 0.99–2.04).ConclusionsMigraine medication use patterns suggesting greater underlying migraine severity were associated with increased risk of SAB. This research adds to the limited information available on the reproductive effects of migraine.

【 授权许可】

CC BY   
© The Author(s) 2022

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