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MIGRAINE AND PREGNANCY.

Stephen D. Silberstein1

  • 1Jefferson Headache Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, U.S.A.

Journal SOGC : Journal of the Society of Obstetricians and Gynaecologists of Canada
|November 29, 2002
PubMed
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Clinical Trials Report.

Current neurology and neuroscience reportsยท2002
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Migraine treatment during pregnancy requires careful consideration. While most medications are not teratogenic, nonpharmacologic options are preferred, with limited use of analgesics if necessary.

Area of Science:

  • Neurology
  • Obstetrics
  • Pharmacology

Background:

  • Migraine affects 18% of women, with many experiencing changes during pregnancy.
  • Pregnancy can alter migraine patterns, with some women experiencing onset or recurrence postpartum.
  • Despite medication use, migraineurs show no increased risk of adverse pregnancy outcomes like miscarriage or congenital anomalies.

Purpose of the Study:

  • To review migraine management in pregnant women.
  • To assess the risks of medication use versus untreated migraine during pregnancy.
  • To provide guidance on pharmacologic and nonpharmacologic treatment options.

Main Methods:

  • Literature review of studies on migraine in pregnancy.
  • Analysis of adverse event data in pregnant migraineurs.

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  • Evaluation of treatment efficacy and safety.

    • Main Results:

    • Most drugs used for migraine are not teratogenic.
    • Adverse effects of medications depend on dose, route, timing, and developmental stage.
    • The risk of severe, untreated migraine (status migrainosus) to the fetus may outweigh medication risks.

    Conclusions:

    • Nonpharmacologic treatments are the preferred approach for migraine during pregnancy.
    • Limited use of analgesics like acetaminophen and opioids is acceptable.
    • Preventive therapy should be considered only as a last resort.