Experiencing acute severe migraine attacks during pregnancy may indicate particularly severe and active disease. Data regarding delivery outcomes in this population is lacking. We aimed to describe birth outcomes in pregnant patients presenting to the hospital setting with acute severe migraine attacks.METHODS:
We reviewed pregnancy and delivery records of consecutive inpatient neurology consultations for acute headache in pregnant women at a tertiary hospital over a 5 year period.RESULTS:
Ninety pregnant women with acute migraine had a mean age of 29.3 years. Nearly half had migraine with aura (40.7%), 12.8% had chronic migraine, and 31.4% presented in status migrainosus. Delivery complications included 54.4% for at least one adverse outcome, 28.2% for preterm delivery, 20.5% for preeclampsia, 30.8% for Cesarean delivery, and 19.2% for low birthweight. In binary logistic regression analysis, migraine with aura was associated with a lower rate (OR 0.28, 95% CI 0.09–0.86) but chronic migraine (OR 1.59, 95% CI 0.29–8.78) and status migrainosus (OR 0.66, 95% CI 0.22–2.02) were not associated with adverse pooled outcomes. Age at or above 35 was independently associated with adverse outcomes (OR 7.37, 95% CI 1.97–30.4).CONCLUSION:
Pregnant women seeking acute migraine treatment experienced a higher rate of preterm delivery, preeclampsia and low birthweight but a lower rate of cesarean delivery than the general population. However, there were no independent associations with chronic migraine or status migrainosus. Nonetheless, with more than half of patients in this study experiencing some type of adverse birth outcome pregnancies in such patients should be considered high risk.