Skip to main content
Top
Published in: Current Neurology and Neuroscience Reports 4/2014

01-04-2014 | Headache (R Halker, Section Editor)

Migraine in Pregnancy and Lactation

Authors: Paru S. David, Juliana M. Kling, Amaal J. Starling

Published in: Current Neurology and Neuroscience Reports | Issue 4/2014

Login to get access

Abstract

Migraine headache is a significant health problem affecting women more than men. In women, the hormonal fluctuations seen during pregnancy and lactation can affect migraine frequency and magnitude. Understanding the evaluation of headache in pregnancy is important, especially given the increased risk of secondary headache conditions. Pregnancy and lactation can complicate treatment options for women with migraine because of the risk of certain medications to the fetus. This review includes details of the workup and then provides treatment options for migraine during pregnancy and lactation.
Literature
1.
go back to reference Stovner L et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27(3):193–210.PubMedCrossRef Stovner L et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27(3):193–210.PubMedCrossRef
3.
go back to reference Granella F et al. Migraine with aura and reproductive life events: a case control study. Cephalalgia. 2000;20(8):701–7.PubMedCrossRef Granella F et al. Migraine with aura and reproductive life events: a case control study. Cephalalgia. 2000;20(8):701–7.PubMedCrossRef
4.
go back to reference Lipton RB et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache. 2001;41(7):646–57.PubMedCrossRef Lipton RB et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache. 2001;41(7):646–57.PubMedCrossRef
5.
go back to reference Granella F et al. Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache. 1993;33(7):385–9.PubMedCrossRef Granella F et al. Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache. 1993;33(7):385–9.PubMedCrossRef
6.
go back to reference Marcus DA, Scharff L, Turk D. Longitudinal prospective study of headache during pregnancy and postpartum. Headache. 1999;39(9):625–32.PubMedCrossRef Marcus DA, Scharff L, Turk D. Longitudinal prospective study of headache during pregnancy and postpartum. Headache. 1999;39(9):625–32.PubMedCrossRef
7.
go back to reference Mattsson P. Hormonal factors in migraine: a population-based study of women aged 40 to 74 years. Headache. 2003;43(1):27–35.PubMedCrossRef Mattsson P. Hormonal factors in migraine: a population-based study of women aged 40 to 74 years. Headache. 2003;43(1):27–35.PubMedCrossRef
8.
go back to reference Sances G et al. Course of migraine during pregnancy and postpartum: a prospective study. Cephalalgia. 2003;23(3):197–205.PubMedCrossRef Sances G et al. Course of migraine during pregnancy and postpartum: a prospective study. Cephalalgia. 2003;23(3):197–205.PubMedCrossRef
9.••
go back to reference Kvisvik EV et al. Headache and migraine during pregnancy and puerperium: the MIGRA-study. J Headache Pain. 2011;12(4):443–51. This large, prospective trial confirms that most women have improvement in migraine during pregnancy, yet a number of women do have migraine that persists in pregnancy. Also, it demonstrates an increase in postpartum migraine after delivery in most women.PubMedCentralPubMedCrossRef Kvisvik EV et al. Headache and migraine during pregnancy and puerperium: the MIGRA-study. J Headache Pain. 2011;12(4):443–51. This large, prospective trial confirms that most women have improvement in migraine during pregnancy, yet a number of women do have migraine that persists in pregnancy. Also, it demonstrates an increase in postpartum migraine after delivery in most women.PubMedCentralPubMedCrossRef
10.
go back to reference Melhado EM, Maciel Jr JA, Guerreiro CA. Headache during gestation: evaluation of 1101 women. Can J Neurol Sci. 2007;34(2):187–92.PubMed Melhado EM, Maciel Jr JA, Guerreiro CA. Headache during gestation: evaluation of 1101 women. Can J Neurol Sci. 2007;34(2):187–92.PubMed
11.
12.•
go back to reference Hoshiyama E et al. Postpartum migraines: a long-term prospective study. Intern Med. 2012;51(22):3119–23. This prospective study looks at migraine in the first year postpartum and shows that women who breastfeed have fewer migraines than women who bottle feed.PubMed Hoshiyama E et al. Postpartum migraines: a long-term prospective study. Intern Med. 2012;51(22):3119–23. This prospective study looks at migraine in the first year postpartum and shows that women who breastfeed have fewer migraines than women who bottle feed.PubMed
13.
go back to reference Allais G et al. The risks of women with migraine during pregnancy. Neurol Sci. 2010;31 Suppl 1:S59–61.PubMedCrossRef Allais G et al. The risks of women with migraine during pregnancy. Neurol Sci. 2010;31 Suppl 1:S59–61.PubMedCrossRef
14.
go back to reference Facchinetti F et al. The relationship between headache and preeclampsia: a case-control study. Eur J Obstet Gynecol Reprod Biol. 2005;121(2):143–8.PubMedCrossRef Facchinetti F et al. The relationship between headache and preeclampsia: a case-control study. Eur J Obstet Gynecol Reprod Biol. 2005;121(2):143–8.PubMedCrossRef
15.
go back to reference Sanchez SE et al. Headaches and migraines are associated with an increased risk of preeclampsia in Peruvian women. Am J Hypertens. 2008;21(3):360–4.PubMedCrossRef Sanchez SE et al. Headaches and migraines are associated with an increased risk of preeclampsia in Peruvian women. Am J Hypertens. 2008;21(3):360–4.PubMedCrossRef
16.
go back to reference Facchinetti F et al. Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalalgia. 2009;29(3):286–92.PubMedCrossRef Facchinetti F et al. Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalalgia. 2009;29(3):286–92.PubMedCrossRef
17.
go back to reference Bushnell CD, Jamison M, James AH. Migraines during pregnancy linked to stroke and vascular diseases: US population based case-control study. BMJ. 2009;338:b664.PubMedCentralPubMedCrossRef Bushnell CD, Jamison M, James AH. Migraines during pregnancy linked to stroke and vascular diseases: US population based case-control study. BMJ. 2009;338:b664.PubMedCentralPubMedCrossRef
19.
go back to reference Marcus DA. Managing headache during pregnancy and lactation. Expert Rev Neurother. 2008;8(3):385–95.PubMedCrossRef Marcus DA. Managing headache during pregnancy and lactation. Expert Rev Neurother. 2008;8(3):385–95.PubMedCrossRef
21.
22.
go back to reference Garcia-Bournissen F, Shrim A, Koren G. Safety of gadolinium during pregnancy. Can Fam. 2006;52:309–10. Garcia-Bournissen F, Shrim A, Koren G. Safety of gadolinium during pregnancy. Can Fam. 2006;52:309–10.
23.
24.
go back to reference Marcus DA, Scharff L, Turk DC. Nonpharmacological management of headaches during pregnancy. Psychosom Med. 1995;57(6):527–35.PubMed Marcus DA, Scharff L, Turk DC. Nonpharmacological management of headaches during pregnancy. Psychosom Med. 1995;57(6):527–35.PubMed
25.
go back to reference Scharff L, Marcus DA, Turk DC. Maintenance of effects in the nonmedical treatment of headaches during pregnancy. Headache. 1996;36(5):285–90.PubMedCrossRef Scharff L, Marcus DA, Turk DC. Maintenance of effects in the nonmedical treatment of headaches during pregnancy. Headache. 1996;36(5):285–90.PubMedCrossRef
26.
go back to reference Loder E. Safety of sumatriptan in pregnancy: a review of the data so far. CNS Drugs. 2003;17(1):1–7.PubMedCrossRef Loder E. Safety of sumatriptan in pregnancy: a review of the data so far. CNS Drugs. 2003;17(1):1–7.PubMedCrossRef
28.
go back to reference Nezvalova-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(4):563–75.PubMedCrossRef Nezvalova-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(4):563–75.PubMedCrossRef
29.
go back to reference Olesen C et al. Pregnancy outcome following prescription for sumatriptan. Headache. 2000;40(1):20–4.PubMedCrossRef Olesen C et al. Pregnancy outcome following prescription for sumatriptan. Headache. 2000;40(1):20–4.PubMedCrossRef
31.
go back to reference Rakel D. Integrative medicine. 3rd ed. Philadelphia: Saunders; 2012. Rakel D. Integrative medicine. 3rd ed. Philadelphia: Saunders; 2012.
32.
go back to reference Evers S et al. EFNS guideline on the drug treatment of migraine - report of an EFNS task force. Eur J Neurol. 2006;13(6):560–72.PubMedCrossRef Evers S et al. EFNS guideline on the drug treatment of migraine - report of an EFNS task force. Eur J Neurol. 2006;13(6):560–72.PubMedCrossRef
33.
go back to reference Airola G et al. Non-pharmacological management of migraine during pregnancy. Neurol Sci. 2010;31 Suppl 1:S63–5.PubMedCrossRef Airola G et al. Non-pharmacological management of migraine during pregnancy. Neurol Sci. 2010;31 Suppl 1:S63–5.PubMedCrossRef
35.
go back to reference Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108(3):776–89. Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108(3):776–89.
36.
go back to reference Nice FJ, Luo AC. Medications and breast-feeding: current concepts. J Am Pharm Assoc. 2012;52(1):86–94.CrossRef Nice FJ, Luo AC. Medications and breast-feeding: current concepts. J Am Pharm Assoc. 2012;52(1):86–94.CrossRef
38.
go back to reference Hale T. Medication and mothers' milk. 14th ed. Amarillo: Hale; 2010. Hale T. Medication and mothers' milk. 14th ed. Amarillo: Hale; 2010.
39.
go back to reference Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 9th ed. Philadelphia: Lippincott Wilkins and Williams; 2011. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 9th ed. Philadelphia: Lippincott Wilkins and Williams; 2011.
40.
go back to reference Atkinson HC, Begg EJ, Darlow BA. Drugs in human milk. Clinical pharmacokinetic considerations. Clin Pharmacokinet. 1988;14(4):217–40.PubMedCrossRef Atkinson HC, Begg EJ, Darlow BA. Drugs in human milk. Clinical pharmacokinetic considerations. Clin Pharmacokinet. 1988;14(4):217–40.PubMedCrossRef
Metadata
Title
Migraine in Pregnancy and Lactation
Authors
Paru S. David
Juliana M. Kling
Amaal J. Starling
Publication date
01-04-2014
Publisher
Springer US
Published in
Current Neurology and Neuroscience Reports / Issue 4/2014
Print ISSN: 1528-4042
Electronic ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-014-0439-7

Other articles of this Issue 4/2014

Current Neurology and Neuroscience Reports 4/2014 Go to the issue

Neuro-Oncology (LE Abrey, Section Editor)

Targeted Therapy in Pediatric Low-Grade Glioma

Headache (R Halker, Section Editor)

Thunderclap Headache

Neuro-Oncology (LE Abrey, Section Editor)

The Role of Brain Tumor Advocacy Groups

Neuro-Oncology (LE Abrey, Section Editor)

Microenvironmental Clues for Glioma Immunotherapy