The Impact of Migraine on Pregnancy Plan: Insights from the American Registry for Migraine Research (ARMR)

Ryotaro Ishii, MD, PhD

AHSAM 2020 - Oral session
Published on September 24, 2020 | NEW

5 minute listen

7 minute read

Key messages

  • Previous studies have focused upon the impact of pregnancy on migraine patterns, but there is a large migraine burden on pregnancy planning.
  • In particular, migraine impacted the pregnancy planning of the young, those with menstrual migraine, chronic migraine and those without children.
  • Migrainous females avoided pregnancy because they believed their migraine pattern would worsen during pregnancy and make their pregnancy difficult.
  • Previous observations showed most women have migraine improvements during pregnancy.
  • The education of migrainous females about the impact of pregnancy on their disease is important.
  • Background

    What do we already know about this topic?
  • Findings

    What does this study add?
  • Perspectives

    How does this study impact clinical practice?
  • Expert commentary

    by Rebecca Burch, MD, FAHS

Key messages

  • Previous studies have focused upon the impact of pregnancy on migraine patterns, but there is a large migraine burden on pregnancy planning.
  • In particular, migraine impacted the pregnancy planning of the young, those with menstrual migraine, chronic migraine and those without children.
  • Migrainous females avoided pregnancy because they believed their migraine pattern would worsen during pregnancy and make their pregnancy difficult.
  • Previous observations showed most women have migraine improvements during pregnancy.
  • The education of migrainous females about the impact of pregnancy on their disease is important.

Background

What do we already know about this topic?

  • Migraine negatively affects a patient’s quality of life during and between attacks, impacting their career, social activity and relationships.
  • Previous studies have shown approximately 1% of females with migraine had fewer children or avoided having children, while 3.2% chose not to have children, delayed or had fewer children due to migraines.1,2
  • The American Registry for Migraine Research (ARMR) is a multicenter registry of patients diagnosed by a specialist according to the International Classification of Headache Disorders-3 (ICHD-3). 3

How was this study conducted?

  • The ARMR database was used to identify female patients with any migraine diagnosis who had completed the pregnancy planning questions between February 2016 and September 2019 (N=1112).
  • Excluded patients with trigeminal autonomic cephalalgias (TACs), secondary headache, painful cranial neuropathies, other facial pain and other headaches.
  • Data was subdivided into Avoid Pregnancy (AP) and No Impact (NI) groups based upon the response to a closed question regarding migraines impacting pregnancy plans.

Findings

What does this study add?

  • 19.9% females with a migraine diagnosis avoided pregnancy to some extent because of migraine.
  • The AP group was significantly younger than the NI group and had significantly fewer children.
  • Compared to the NI group, the AP group had a higher proportion of chronic migraine, menstrual migraine, depression, frequency of headache days and higher Migraine Disability Assessment (MIDAS) scores.
  • In the AP group, 72.5% believed migraine would worsen during pregnancy and 68.3% believed migraine would make their pregnancy very difficult.
  • There was no significant difference in sociodemographics between the AP and NI groups.

Perspectives

How does this study impact clinical practice?

  • As previous observations have shown, most women have migraine improvements during pregnancy, it is important to educate women with migraine about the true impact of pregnancy on their disease.
  • Due to the paucity of studies, further research is required on the impact of migraine on pregnancy plans of female patients with a history of migraine.

Perspectives

How does this study impact clinical practice?

  • As previous observations have shown, most women have migraine improvements during pregnancy, it is important to educate women with migraine about the true impact of pregnancy on their disease.
  • Due to the paucity of studies, further research is required on the impact of migraine on pregnancy plans of female patients with a history of migraine.

This is a highlights summary of an oral session given at the AHSAM 2020 Virtual Annual Scientific Meeting and presented by:

Ryotaro Ishii, MD, PhD
Mayo Clinic
Scottsdale, Arizona

The content is produced by Infomedica, the official reporting partner of ASHAM 2020 Virtual Annual Scientific Meeting. The summary text was drafted by Goldcrest Medical Writing, reviewed by Marco Vercellino, MD, an independent external expert, and approved by Jessica Ailani, MD, FAHS and Mark J. Burish, MD, PhD, the scientific editors of the program.

The presenting authors of the original session had no part in the creation of this conference highlights summary.

In addition, an expert commentary on the topic has been provided by:

Rebecca Burch, MD, FAHS
Brigham and Women's Hospital, Harvard Medical School, Boston, MA

Rebecca Burch, MD, FAHS
Brigham and Women's Hospital, Harvard Medical School, Boston, MA

Dr. Burch is a fellowship-trained, board certified Headache Medicine specialist at the John R. Graham Headache Center of Brigham and Women's Hospital and is director of the Brigham and Women’s /Massachusetts General/Harvard Headache Medicine Fellowship. She is on the Board of Directors for the Headache Cooperative of New England, where she serves as an educational co-director, and the American Headache Society. Dr. Burch serves as an Associate Editor for the journal Neurology. Her research interests include headache epidemiology, preventive treatment of migraine, and women’s health.

1. Lampl C, Thomas H, Stovner LJ, et al. Interictal burden attributable to episodic headache: findings from the Eurolight project. The Journal of Headache and Pain 2016;17:9.

2. Buse DC, Fanning KM, Reed ML, et al. Life With Migraine: Effects on Relationships, Career, and Finances From the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study. Headache 2019;59:1286-1299.

3. Schwedt TJ, Digre K, Tepper SJ, et al. The American Registry for Migraine Research: Research Methods and Baseline Data for an Initial Patient Cohort. Headache 2020;60:337-347. 



Headache
Migraine


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