title: Course of migraine during pregnancy and postpartum: a prospective study.
abstract: The aim of this study was to investigate prospectively the course of migraine during pregnancy and postpartum. Of all the pregnant women consecutively attending an obstetrics and gynaecology department for a routine first-trimester antenatal check-up, 49 migraine sufferers--two were affected by migraine with aura (MA) and 47 by migraine without aura (MO)--who had experienced at least one attack during the 3 months preceding pregnancy were identified, enrolled in the study and given a headache diary. Subsequent examinations were performed at the end of the second and third trimesters and 1 month after delivery. Migraine was seen to improve in 46.8% of the 47 MO sufferers during the first trimester, in 83.0% during the second and in 87.2% during the third, while complete remission was attained by 10.6%, 53.2%, and 78.7% of the women, respectively. Migraine recurred during the first week after childbirth in 34.0% of the women and during the first month in 55.3%. Certain risk factors for lack of improvement of migraine during pregnancy were identified: the presence of menstrually related migraine before pregnancy was associated with a lack of headache improvement in the first and third trimesters, while second-trimester hyperemesis, and a pathological pregnancy course were associated with a lack of headache improvement in the second trimester. Breast feeding seemed to protect from migraine recurrence during postpartum.
authors.affiliation: Headache Centre, IRCCS C. Mondino Foundation, Institute of Neurology, Pavia, Italy. grazia.sances@mondino.it
authors.forename: G
authors.initials: G
authors.lastname: Sances
authors.forename: F
authors.initials: F
authors.lastname: Granella
authors.forename: R E
authors.initials: RE
authors.lastname: Nappi
authors.forename: A
authors.initials: A
authors.lastname: Fignon
authors.forename: N
authors.initials: N
authors.lastname: Ghiotto
authors.forename: F
authors.initials: F
authors.lastname: Polatti
authors.forename: G
authors.initials: G
authors.lastname: Nappi
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008499:Medical Records; D008881:Migraine Disorders / Q000175:diagnosis / Q000503:physiopathology*; D015999:Multivariate Analysis; D049590:Postpartum Period / Q000502:physiology* / Q000523:psychology; D011247:Pregnancy / Q000502:physiology* / Q000523:psychology; D011261:Pregnancy Trimester, First / Q000502:physiology / Q000523:psychology; D011262:Pregnancy Trimester, Second / Q000502:physiology / Q000523:psychology; D011263:Pregnancy Trimester, Third / Q000502:physiology / Q000523:psychology; D011446:Prospective Studies