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Published in: Current Pain and Headache Reports 4/2011

01-08-2011

Headaches During Pregnancy

Authors: Rossella E. Nappi, Francesca Albani, Grazia Sances, Erica Terreno, Emanuela Brambilla, Franco Polatti

Published in: Current Pain and Headache Reports | Issue 4/2011

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Abstract

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.
Literature
1.
go back to reference Stovner Lj, Hagen K, Jensen R, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210.PubMedCrossRef Stovner Lj, Hagen K, Jensen R, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210.PubMedCrossRef
3.
go back to reference Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American migraine study II. Headache. 2001;41:646–57.PubMedCrossRef Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American migraine study II. Headache. 2001;41:646–57.PubMedCrossRef
4.
go back to reference Rasmussen BK. Epidemiology of headache. Cephalalgia. 1995;15:45–68.PubMed Rasmussen BK. Epidemiology of headache. Cephalalgia. 1995;15:45–68.PubMed
5.
go back to reference Martin VT, Behbehani M. Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis–part 1. Headache. 2006;46:3–23.PubMedCrossRef Martin VT, Behbehani M. Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis–part 1. Headache. 2006;46:3–23.PubMedCrossRef
6.
go back to reference Martin VT, Behbehani M. Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis–part 2. Headache. 2006;46:365–86.PubMedCrossRef Martin VT, Behbehani M. Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis–part 2. Headache. 2006;46:365–86.PubMedCrossRef
7.
go back to reference Somerville BW. A study of migraine in pregnancy. Neurology. 1972;22:824–8.PubMed Somerville BW. A study of migraine in pregnancy. Neurology. 1972;22:824–8.PubMed
10.
11.
go back to reference •• Adeney KL, Williams MA: Migraine headaches and preeclampsia: an epidemiologic review. Headache 2006, 46:794–803. This is a good review of the available evidences, suggesting that migraines and preeclampsia may reflect an underlying predisposition toward ischemic injury. •• Adeney KL, Williams MA: Migraine headaches and preeclampsia: an epidemiologic review. Headache 2006, 46:794–803. This is a good review of the available evidences, suggesting that migraines and preeclampsia may reflect an underlying predisposition toward ischemic injury.
12.
go back to reference Torelli P, Allais G, Manzoni GC. Clinical review of headache in pregnancy. Neurol Sci. 2010;31 Suppl 1:S55–8.PubMedCrossRef Torelli P, Allais G, Manzoni GC. Clinical review of headache in pregnancy. Neurol Sci. 2010;31 Suppl 1:S55–8.PubMedCrossRef
14.
go back to reference • Aegidius K, Zwart JA, Hagen K, Stovner L: The effect of pregnancy and parity on headache prevalence: the Head-HUNT study. Headache 2009, 49:851–859. This article includes evidence on the impact of parity on the natural history of migraine and headache during pregnancy. • Aegidius K, Zwart JA, Hagen K, Stovner L: The effect of pregnancy and parity on headache prevalence: the Head-HUNT study. Headache 2009, 49:851–859. This article includes evidence on the impact of parity on the natural history of migraine and headache during pregnancy.
15.
go back to reference Ertresvag JM, Swart J-A, Helde G, et al. Headache and transient focal neurological symptoms during pregnancy, a prospective cohort. Acta Neurol Scand. 2005;111:233–7.PubMedCrossRef Ertresvag JM, Swart J-A, Helde G, et al. Headache and transient focal neurological symptoms during pregnancy, a prospective cohort. Acta Neurol Scand. 2005;111:233–7.PubMedCrossRef
16.
go back to reference Lance JW, Anthony M. Some clinical aspects of migraine. A prospective survey of 500 patients. Arch Neurol. 1966;15:356–61.PubMed Lance JW, Anthony M. Some clinical aspects of migraine. A prospective survey of 500 patients. Arch Neurol. 1966;15:356–61.PubMed
17.
go back to reference Callaghan N. The migraine syndrome in pregnancy. Neurology. 1968;18:197–201.PubMed Callaghan N. The migraine syndrome in pregnancy. Neurology. 1968;18:197–201.PubMed
18.
go back to reference Rasmussen BK. Migraine and tension-type headache in a general population: precipitating factors, female hormones, sleep pattern and relation to lifestyle. Pain. 1993;53:65–72.PubMedCrossRef Rasmussen BK. Migraine and tension-type headache in a general population: precipitating factors, female hormones, sleep pattern and relation to lifestyle. Pain. 1993;53:65–72.PubMedCrossRef
19.
go back to reference Granella F, Sances G, Zanferrari C, et al. Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache. 1993;33:385–9.PubMedCrossRef Granella F, Sances G, Zanferrari C, et al. Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache. 1993;33:385–9.PubMedCrossRef
20.
go back to reference Cupini LM, Matteis M, Troisi E, et al. Sex-hormone-related events in migrainous females. A clinical comparative study between migraine with aura and migraine without aura. Cephalalgia. 1995;15:140–4.PubMedCrossRef Cupini LM, Matteis M, Troisi E, et al. Sex-hormone-related events in migrainous females. A clinical comparative study between migraine with aura and migraine without aura. Cephalalgia. 1995;15:140–4.PubMedCrossRef
21.
go back to reference Maggioni F, Alessi C, Maggino T, Zanchin G. Headache during pregnancy. Cephalalgia. 1997;17:765–9.PubMedCrossRef Maggioni F, Alessi C, Maggino T, Zanchin G. Headache during pregnancy. Cephalalgia. 1997;17:765–9.PubMedCrossRef
22.
go back to reference Granella F, Sances G, Pucci E, et al. Migraine with aura and reproductive life events: a case control study. Cephalalgia. 2000;20:701–7.PubMed Granella F, Sances G, Pucci E, et al. Migraine with aura and reproductive life events: a case control study. Cephalalgia. 2000;20:701–7.PubMed
23.
go back to reference Chen TC, Leviton A. Headache recurrence in pregnant women with migraine. Headache. 1994;34:107–10.PubMedCrossRef Chen TC, Leviton A. Headache recurrence in pregnant women with migraine. Headache. 1994;34:107–10.PubMedCrossRef
24.
go back to reference Marcus DA, Scharff L, Turk D. Longitudinal prospective study of headache during pregnancy and postpartum. Headache. 1999;39:625–32.PubMedCrossRef Marcus DA, Scharff L, Turk D. Longitudinal prospective study of headache during pregnancy and postpartum. Headache. 1999;39:625–32.PubMedCrossRef
25.
go back to reference Scharff L, Marcus DA, Turk DC. Headache during pregnancy and in the postpartum: a prospective study. Headache. 1997;37:203–10.PubMedCrossRef Scharff L, Marcus DA, Turk DC. Headache during pregnancy and in the postpartum: a prospective study. Headache. 1997;37:203–10.PubMedCrossRef
26.
go back to reference Sances G, Granella F, Nappi RE, et al. Course of migraine during pregnancy and postpartum: a prospective study. Cephalalgia. 2003;23:197–205.PubMedCrossRef Sances G, Granella F, Nappi RE, et al. Course of migraine during pregnancy and postpartum: a prospective study. Cephalalgia. 2003;23:197–205.PubMedCrossRef
27.
go back to reference Lee LK. Physiological adaptations of pregnancy affecting the nervous system. Semin Neurol. 2007;27:405–10.PubMedCrossRef Lee LK. Physiological adaptations of pregnancy affecting the nervous system. Semin Neurol. 2007;27:405–10.PubMedCrossRef
28.
go back to reference Genazzani AR, Petraglia F, Facchini V, Facchinetti F. Circulating beta-endorphin levels at various stages of life: possible connections with migraine pathogenesis. Cephalalgia. 1983;3 Suppl 1:35–41.PubMed Genazzani AR, Petraglia F, Facchini V, Facchinetti F. Circulating beta-endorphin levels at various stages of life: possible connections with migraine pathogenesis. Cephalalgia. 1983;3 Suppl 1:35–41.PubMed
29.
go back to reference Petraglia F, Florio P, Nappi C, Genazzani AR. Peptide signaling in human placenta and membranes: autocrine, paracrine, and endocrine mechanisms. Endocr Rev. 1996;17:156–86.PubMed Petraglia F, Florio P, Nappi C, Genazzani AR. Peptide signaling in human placenta and membranes: autocrine, paracrine, and endocrine mechanisms. Endocr Rev. 1996;17:156–86.PubMed
30.
go back to reference MacGregor EA. Oestrogen and attacks of migraine with and without aura. Lancet Neurol. 2004;3:354–61.PubMedCrossRef MacGregor EA. Oestrogen and attacks of migraine with and without aura. Lancet Neurol. 2004;3:354–61.PubMedCrossRef
31.
go back to reference Wright GD, Patel MK. Focal migraine and pregnancy. Br Med J. 1986;293:1557–78.CrossRef Wright GD, Patel MK. Focal migraine and pregnancy. Br Med J. 1986;293:1557–78.CrossRef
32.
go back to reference Chancellor AM, Wroe SJ, Cull RE. Migraine occurring for the first time in pregnancy. Headache. 1990;30:224–7.PubMedCrossRef Chancellor AM, Wroe SJ, Cull RE. Migraine occurring for the first time in pregnancy. Headache. 1990;30:224–7.PubMedCrossRef
33.
go back to reference Lucas S. Medication use in the treatment of migraine during pregnancy and lactation. Curr Pain Headache Rep. 2009;13:392–8.PubMedCrossRef Lucas S. Medication use in the treatment of migraine during pregnancy and lactation. Curr Pain Headache Rep. 2009;13:392–8.PubMedCrossRef
34.
go back to reference Nezvalová-Henriksen K, Spigset O, Nordeng H. Triptan exposure during pregnancy and the risk of major congenital malformations and adverse pregnancy outcomes: results from the Norwegian Mother and Child Cohort Study. Headache. 2010;50:563–75.PubMedCrossRef Nezvalová-Henriksen K, Spigset O, Nordeng H. Triptan exposure during pregnancy and the risk of major congenital malformations and adverse pregnancy outcomes: results from the Norwegian Mother and Child Cohort Study. Headache. 2010;50:563–75.PubMedCrossRef
35.
go back to reference Stein GS. Headaches in the first post partum week and their relationship to migraine. Headache. 1981;21:201–5.PubMedCrossRef Stein GS. Headaches in the first post partum week and their relationship to migraine. Headache. 1981;21:201–5.PubMedCrossRef
36.
go back to reference Allais G, Gabellari IC, Borgogno P, De Lorenzo C, Benedetto C. The risks of women with migraine during pregnancy. Neurol Sci. 2010;31 Suppl 1:S59–61.PubMedCrossRef Allais G, Gabellari IC, Borgogno P, De Lorenzo C, Benedetto C. The risks of women with migraine during pregnancy. Neurol Sci. 2010;31 Suppl 1:S59–61.PubMedCrossRef
37.
go back to reference Roberts JM, Pearson G, Cutler J, Lindheimer MD. National Heart Lung and Blood Institute: summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension. 2003;41:437–45.PubMedCrossRef Roberts JM, Pearson G, Cutler J, Lindheimer MD. National Heart Lung and Blood Institute: summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension. 2003;41:437–45.PubMedCrossRef
38.
go back to reference Wilson BJ, Watson MS, Prescott GJ, et al. Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study. BMJ. 2003;326:845–51.PubMedCrossRef Wilson BJ, Watson MS, Prescott GJ, et al. Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study. BMJ. 2003;326:845–51.PubMedCrossRef
39.
go back to reference Rotton WN, Sachtleben MF, Friedman EA. Migraine and eclampsia. Obstet Gynecol. 1959;14:322–30.PubMed Rotton WN, Sachtleben MF, Friedman EA. Migraine and eclampsia. Obstet Gynecol. 1959;14:322–30.PubMed
40.
go back to reference Marcoux S, Berube S, Brisson J, Fabia J. History of migraine and risk of pregnancy-induced hypertension. Epidemiology. 1992;3:53–6.PubMedCrossRef Marcoux S, Berube S, Brisson J, Fabia J. History of migraine and risk of pregnancy-induced hypertension. Epidemiology. 1992;3:53–6.PubMedCrossRef
41.
go back to reference Mattson P. Hormonal factors in migraine: a population-based study of women aged 40 to 74 years. Headache. 2003;43:27–35.CrossRef Mattson P. Hormonal factors in migraine: a population-based study of women aged 40 to 74 years. Headache. 2003;43:27–35.CrossRef
42.
go back to reference Scher AI, Terwindt GM, Picavet HSJ, et al. Cardiovascular risk factors and migraine: the GEM population-based study. Neurology. 2005;64:614–20.PubMedCrossRef Scher AI, Terwindt GM, Picavet HSJ, et al. Cardiovascular risk factors and migraine: the GEM population-based study. Neurology. 2005;64:614–20.PubMedCrossRef
43.
go back to reference Bánhidy F, Acs N, Horváth-Puhó E, Czeizel AE. Pregnancy complications and delivery outcomes in pregnant women with severe migraine. Eur J Obstet Gynecol Reprod Biol. 2007;134:157–63.PubMedCrossRef Bánhidy F, Acs N, Horváth-Puhó E, Czeizel AE. Pregnancy complications and delivery outcomes in pregnant women with severe migraine. Eur J Obstet Gynecol Reprod Biol. 2007;134:157–63.PubMedCrossRef
44.
go back to reference Facchinetti F, Allais G, D’Amico R, Benedetto C, Volpe A. The relationship between headache and preeclampsia: a case-control study. Eur J Obstet Gynecol Reprod Biol. 2005;121:143–8.PubMedCrossRef Facchinetti F, Allais G, D’Amico R, Benedetto C, Volpe A. The relationship between headache and preeclampsia: a case-control study. Eur J Obstet Gynecol Reprod Biol. 2005;121:143–8.PubMedCrossRef
45.
go back to reference Sanchez SE, Qiu C, Williams MA, Lam N, Sorensen TK. Headaches and migraines are associated with an increased risk of preeclampsia in Peruvian women. Am J Hypertens. 2008;21:360–4.PubMedCrossRef Sanchez SE, Qiu C, Williams MA, Lam N, Sorensen TK. Headaches and migraines are associated with an increased risk of preeclampsia in Peruvian women. Am J Hypertens. 2008;21:360–4.PubMedCrossRef
46.
go back to reference •• Facchinetti F, Allais G, Nappi RE et al.: Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalalgia 2009, 29:286–292. This article demonstrates prospectively that the lack of remission of migraine during pregnancy is significantly associated with gestational hypertension/preeclampsia. •• Facchinetti F, Allais G, Nappi RE et al.: Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalalgia 2009, 29:286–292. This article demonstrates prospectively that the lack of remission of migraine during pregnancy is significantly associated with gestational hypertension/preeclampsia.
47.
go back to reference •• Bushnell CD, Jamison M, James AH: Migraine during pregnancy linked to stroke and vascular diseases: US population based case-control study. BMJ 2009, 338:b664. This article documents on a very large sample that migraine during pregnancy is associated with vascular complication. •• Bushnell CD, Jamison M, James AH: Migraine during pregnancy linked to stroke and vascular diseases: US population based case-control study. BMJ 2009, 338:b664. This article documents on a very large sample that migraine during pregnancy is associated with vascular complication.
48.
go back to reference Blair EM, Nelson KB. Migraine and preterm birth. J Perinatol 2010 Dec 23. [Epub ahead of print]. Blair EM, Nelson KB. Migraine and preterm birth. J Perinatol 2010 Dec 23. [Epub ahead of print].
49.
go back to reference •• Chen HM, Chen SF, Chen YH, Lin HC: Increased risk of adverse pregnancy outcomes for women with migraines: a nationwide population-based study. Cephalalgia 2010, 30:433–438. This article reports on a large sample of relevant neonatal outcomes in women with migraine. •• Chen HM, Chen SF, Chen YH, Lin HC: Increased risk of adverse pregnancy outcomes for women with migraines: a nationwide population-based study. Cephalalgia 2010, 30:433–438. This article reports on a large sample of relevant neonatal outcomes in women with migraine.
50.
go back to reference Sanchez SE, Williams MA, Pacora PN, et al. Risk of placental abruption in relation to migraines and headaches. BMC Womens Health. 2010;10:30.PubMedCrossRef Sanchez SE, Williams MA, Pacora PN, et al. Risk of placental abruption in relation to migraines and headaches. BMC Womens Health. 2010;10:30.PubMedCrossRef
Metadata
Title
Headaches During Pregnancy
Authors
Rossella E. Nappi
Francesca Albani
Grazia Sances
Erica Terreno
Emanuela Brambilla
Franco Polatti
Publication date
01-08-2011
Publisher
Current Science Inc.
Published in
Current Pain and Headache Reports / Issue 4/2011
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-011-0200-8

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