The following is a summary of “Migraine Diagnosis, Medication Use, and Spontaneous Abortion Before Pregnancy: A Prospective Cohort Study,” published in the December 2022 issue. headache and pain by Crow et al.
Migraine affects 17–24% of women of childbearing age, and its incidence is influenced by underlying central nervous system excitability, autoimmune disorders, and autonomic dysfunction, affecting female fertility. It may be related. This study analyzed the relationship between migraine history and preconception prophylaxis use and women’s chances of spontaneous abortion (SAB). Investigators examined information collected from women who planned a pregnancy before becoming pregnant (2013–2021). Women (n=7,890) from the United States or Canada who identified as female and became pregnant during study follow-up were considered eligible.
Participants completed a baseline survey and two additional surveys every other month for 12 months or until they reported pregnancy, whichever came first. Participants then filled out questionnaires both during the first trimester (approximately 8-9 weeks) and the third trimester (approximately 32 weeks). Individuals who identified as migraine sufferers or who used medications to treat migraines were classified as migraine sufferers. Migraine drug use over the past 4 weeks was obtained via preconception questionnaires and SAB was elicited via postconception and pregnancy questionnaires. Using a Cox regression model with gestational age as the timescale to account for potential demographic, medical, and lifestyle confounding factors to predict preconception migraine, migraine drug use, and SAB A hazard ratio (HR) and 95% CI for the association could be estimated.
Among the pregnancies in this study, the abortion rate for SAB was 19%. Preconception migraine was not significantly associated with SAB risk (HR=1.03, 95% CI=0.91-1.06). Overall, migraine drug use was associated with a modest increase in the incidence of SAB (HR=1.14, 95% CI=0.96-1.36). Those who used migraine medication daily had the highest risk (HR = 1.38, 95% CI: 0.81-2.35), followed by migraine prophylaxis (HR = 1.43, 95% CI: 0.72-2.84) or analgesics. Followed by those who took it. With caffeine (HR = 1.42, 95% CI: 0.99-2.04). The incidence of SAB was higher in people whose migraine drug use was consistent with more severe underlying migraine headaches. is added to