(847) Perinatal outcomes in pregnant patients with a history of migraine headaches

To examine maternal and neonatal outcomes among pregnant patients with and without a history of migraine headaches.

Study Design:

We conducted a retrospective cohort study of births in the state of California from 2008-2020 to compare perinatal outcomes between those with and without history of migraine headaches. Singleton, non-anomalous deliveries at 23-42 weeks of gestation were used. Outcomes included gestational hypertension, preeclampsia, severe maternal morbidity (SMM), preterm birth ( < 37 weeks), NICU admission, and respiratory distress syndrome (RDS).  We performed multivariable logistic regression controlling for age, race/ethnicity, education, pre-pregnancy BMI, parity, and insurance status to estimate adjusted odds ratios (aOR) with 95% confidence intervals.

Results:

In the cohort of 5,065,732 individuals, there were 48,518 (0.96%) individuals with history of migraines.  There were higher rates of migraines among those who were white, highly educated, and privately insured. On multivariable regression, those with migraines had higher odds of gestational hypertension (7.1% vs 3.4%; aOR 1.75, 95% CI 1.69-1.82), preeclampsia (6.7% vs 3.8%; aOR 1.70, 95% CI 1.64-1.76), SMM (2.0% vs 1.2%; aOR 1.71, 95% CI 1.61-1.83), preterm delivery (8.8% vs 6.4%; aOR 1.45, 95% CI 1.40-1.50), and neonatal RDS (4.5% vs 2.3%; aOR 1.75, 95% CI 1.67-1.83).

Conclusion:

In this large cohort of pregnant patients, those with a history of migraines were more likely to experience adverse perinatal outcomes, despite the presence of multiple protective social determinants with respect to socioeconomic status and experience of racism. This signals that there may be physiologic or structural vulnerabilities among individuals with migraines contributing to adverse outcomes during pregnancy which require further characterization.