Migraines during pregnancy linked to stroke and vascular diseases: US population based case-control study.
OBJECTIVE
To examine the association between migraine and cardiovascular diseases during pregnancy. Design US population based case-control study.


METHODS
Nationwide inpatient sample, from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. Population 18,345,538 pregnancy related discharges from 2000 to 2003.


METHODS
Diagnosis of migraine, as identified by ICD-9 codes 346.0 and 346.1. Stroke and other vascular diseases were identified by using standard ICD-9 codes.


RESULTS
From the hospital discharges with a pregnancy discharge code, 33 956 migraine codes were identified: 185 per 100 000 deliveries. Diagnoses that were jointly associated with migraine codes during pregnancy (excluding pre-eclampsia) were stroke (odds ratio 15.05, 95% confidence interval 8.26 to 27.4), myocardial infarction/heart disease (2.11, 1.76 to 2.54), pulmonary embolus/venous thromboembolism (3.23, 2.06 to 7.07), and hypertension (8.61, 6.43 to 11.54), as well as pre-eclampsia/gestational hypertension (2.29, 2.13 to 2.46), smoking (2.85, 2.53 to 3.21), and diabetes (1.96, 1.64 to 2.35). However, migraine was not associated with several non-vascular diagnoses (pneumonia, transfusions, postpartum infection or haemorrhage).


CONCLUSIONS
In this large, population based sample of pregnant women admitted to hospital, a strong relation existed between active peripartum migraine and vascular diagnoses during pregnancy. Because these data do not allow determination of which came first, migraine or the vascular condition, prospective studies of pregnant women are needed to explore this association further.
Bushnell
Cheryl D
CD
Department of Neurology, Wake Forest University Health Sciences, Medical Center Boulevard, Winston-Salem, NC 27157, USA. cbushnel@wfubmc.edu
Jamison
Margaret
M
James
Andra H
AH
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008881:Migraine Disorders / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014652:Vascular Diseases / Q000150:complications* / Q000453:epidemiology