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Headache related to pregnancy: Management of migraine and migraine headache in pregnancy

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Evidence-based treatment algorithms are needed for managing headache during conception, pregnancy, and the postpartum period. Whereas most studies seem to indicate that headaches improve for most women during pregnancy (as estrogen levels increase), this often is not the case in women with more severe, frequent migraine. Few pharmacologic studies include pregnant women, so evidence-based treatments are lacking. Pregnancy registries to record adverse outcomes for various medications and large, population-based studies are needed to analyze the behavior of chronic headache, particularly chronic migraine, during pregnancy. Collaboration between headache specialists and obstetricians is needed to promote research and education for the optimal management of headache during pregnancy.

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References and Recommended Reading

  1. Brandes JL: The influence of estrogen on migraine: a systematic review. JAMA 2006, 295:1824–1830.

    Article  PubMed  CAS  Google Scholar 

  2. Sances G, Granella F, Nappi RE, et al.: Course of migraine during pregnancy and postpartum: a prospective study. Cephalalgia 2003, 23:197–205.

    Article  PubMed  CAS  Google Scholar 

  3. Marcus DA, Scharff L, Turk D: Longitudinal prospective study of headache during pregnancy and postpartum. Headache 1999, 39:625–632.

    Article  PubMed  CAS  Google Scholar 

  4. Scharff L, Marcus DA, Turk DC: Headache during pregnancy and in the postpartum: a prospective study. Headache 1997, 37:203–210.

    Article  PubMed  CAS  Google Scholar 

  5. Somerville BW: A study of migraine in pregnancy. Neurology 1972, 22:824–828.

    PubMed  CAS  Google Scholar 

  6. Wall VR: Breastfeeding and migraine headaches. J Hum Lact 1992, 8:209–212.

    Article  PubMed  CAS  Google Scholar 

  7. 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.

    Article  PubMed  CAS  Google Scholar 

  8. Wainscott G, Sullivan FM, Volans GN, Wilkinson M: The outcome of pregnancy in women suffering from migraine. Postgrad Med J 1978, 54:98–102.

    PubMed  CAS  Google Scholar 

  9. Aube M: Migraine in pregnancy. Neurology 1999, 53:S26–S28.

    PubMed  CAS  Google Scholar 

  10. Ertresvg JM, Stovner LJ, Kvavik LE, et al.: Migraine aura or transient ischemic attacks? A five-year follow-up case-control study of women with transient central nervous system disorders in pregnancy. BMC Med 2007, 5:19.

    Article  PubMed  Google Scholar 

  11. Silberstein SD: Migraine and pregnancy. Neurol Clin 1997, 15:209–231.

    Article  PubMed  CAS  Google Scholar 

  12. Marcus DA: Pregnancy and chronic headache. Expert Opin Pharmacother 2002, 3:389–393.

    Article  PubMed  CAS  Google Scholar 

  13. Gülmezoglu AM, Hofmeyr GJ: Calcium channel blockers for potential impaired fetal growth. Cochrane Database Syst Rev 2000, 2:CD000049.

    Google Scholar 

  14. Sorensen HT, Czeizel AE, Rockenbauer M, et al.: The risk of limb deficiencies and other congenital abnormalities in children exposed in utero to calcium channel blockers. Acta Obstet Gynecol Scand 2001, 80:397–401.

    Article  PubMed  CAS  Google Scholar 

  15. Palmieri C, Canger R: Teratogenic potential of the newer antiepileptic drugs: what is known and how should this influence prescribing? CNS Drugs 2002, 16:755–764.

    Article  PubMed  CAS  Google Scholar 

  16. Thomas SV, Indrani L, Devi GC, et al.: Pregnancy in women with epilepsy: preliminary results of kerala registry of epilepsy and pregnancy. Neurol India 2001, 49:60–66.

    PubMed  CAS  Google Scholar 

  17. Topiramate (prescribing information). In Physicians’ Desk Reference 2006. Montvale, NJ: Thomson Healthcare; 2006:2442.

  18. Bigal ME, Lipton RB: Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology 2006, 67:252–257.

    Article  PubMed  Google Scholar 

  19. Carp HJ, Fein A, Nebel L: Effect of diclofenac on implantation and embryonic development in the rat. Eur J Obstet Gynecol Reprod Biol 1988, 28:273–277.

    Article  PubMed  CAS  Google Scholar 

  20. Kanayama K, Osada H, Nariai K, Endo T: Inhibitory effects of indomethacin on implantation and its related phenomena. J Int Med Res 1996, 24:358–362.

    PubMed  CAS  Google Scholar 

  21. Momma K, Uemura S, Nishihara S, Ota Y: Dilatation of the ductus arteriosus by prostaglandins and prostaglandin’s precursors. Pediatr Res 1980, 14:1074–1077.

    Article  PubMed  CAS  Google Scholar 

  22. Rein AJ, Nadjari M, Elchalal U, Nir A: Contraction of the fetal ductus arteriosus induced by diclofenac. Case report. Fetal Diagn Ther 1999, 14:24–25.

    Article  PubMed  CAS  Google Scholar 

  23. Morris JL, Rosen DA, Rosen KR: Nonsteroidal anti-inflammatory agents in neonates. Paediatr Drugs 2003, 5:385–405.

    PubMed  Google Scholar 

  24. Stein GS: Headaches in the first post partum week and their relationship to migraine. Headache 1981, 21:201–205.

    Article  PubMed  CAS  Google Scholar 

  25. Stein G, Morton J, Marsh A, et al.: Headaches after childbirth. Acta Neurol Scand 1984, 69:74–79.

    Article  PubMed  CAS  Google Scholar 

  26. Granella F, Sances G, Zanferrari C, et al.: Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women. Headache 1993, 33:385–389.

    Article  PubMed  CAS  Google Scholar 

  27. American Academy of Pediatrics Committee on Drugs: The transfer of drugs and other chemicals into human milk. Pediatrics 2001, 108:776–789.

    Article  Google Scholar 

  28. Simpkins JW, Field FP, Torosian G, Soltis EE: Effects of prenatal exposure to tricyclic antidepressants on adrenergic responses in progeny. Dev Pharmacol Ther 1985, 8:17–33.

    PubMed  CAS  Google Scholar 

  29. Diekman MA, Green ML: Mycotoxins and reproduction in domestic livestock. J Anim Sci 1992, 70:1615–1627.

    PubMed  CAS  Google Scholar 

  30. Baskett TF: A flux of reds: evolution of active management of the third stage of labor. J R Soc Med 2000, 93:489–493.

    PubMed  CAS  Google Scholar 

  31. Briggs GG, Freeman RK, Yaffe SJ: Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risks, edn 5. Baltimore, MD: Williams & Wilkins; 1998.

    Google Scholar 

  32. Friedman JM, Polifka JE: TERIS. Micromedex Reproductive Risk Information System (REPRORISK). Englewood, CO: Thomson MICROMEDEX; 2001.

    Google Scholar 

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Authors and Affiliations

  1. Nashville Neuroscience Group; Department of Neurology, Vanderbilt University School of Medicine, 300 20th Avenue North, Suite 603, Nashville, TN, 37203, USA

    Jan Lewis Brandes

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  1. Jan Lewis Brandes
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Correspondence to Jan Lewis Brandes.

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Brandes, J.L. Headache related to pregnancy: Management of migraine and migraine headache in pregnancy. Curr Treat Options Neurol 10, 12–19 (2008). https://doi.org/10.1007/s11940-008-0002-4

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