Risk of placental abruption in relation to migraines and headaches.
BACKGROUND
Migraine, a common chronic-intermittent disorder of idiopathic origin characterized by severe debilitating headaches and autonomic nervous system dysfunction, and placental abruption, the premature separation of the placenta, share many common pathophysiological characteristics. Moreover, endothelial dysfunction, platelet activation, hypercoagulation, and inflammation are common to both disorders. We assessed risk of placental abruption in relation to maternal history of migraine before and during pregnancy in Peruvian women.


METHODS
Cases were 375 women with pregnancies complicated by placental abruption, and controls were 368 women without an abruption. During in-person interviews conducted following delivery, women were asked if they had physician-diagnosed migraine, and they were asked questions that allowed headaches and migraine to be classified according to criteria established by the International Headache Society. Logistic regression procedures were used to calculate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for confounders.


RESULTS
Overall, a lifetime history of any headaches or migraine was associated with an increased odds of placental abruption (aOR = 1.60; 95% CI 1.16-2.20). A lifetime history of migraine was associated with a 2.14-fold increased odds of placental abruption (aOR = 2.14; 95% CI 1.22-3.75). The odds of placental abruption was 2.11 (95% CI 1.00-4.45) for migraineurs without aura; and 1.59 (95% 0.70-3.62) for migraineurs with aura. A lifetime history of tension-type headache was also increased with placental abruption (aOR = 1.61; 95% CI 1.01-2.57).


CONCLUSIONS
This study adds placental abruption to a growing list of pregnancy complications associated with maternal headache/migraine disorders. Nevertheless, prospective cohort studies are needed to more rigorously evaluate the extent to which migraines and/or its treatments are associated with the occurrence of placental abruption.
Department of Obstetrics and Gynecology, Hospital Nacional dos de Mayo, & Universidad San Martin de Porres, Lima, Peru.
Sixto E
SE
Sanchez
Michelle A
MA
Williams
Percy N
PN
Pacora
Cande V
CV
Ananth
Chungfang
C
Qiu
Sheena K
SK
Aurora
Tanya K
TK
Sorensen
D000037:Abruptio Placentae / Q000453:epidemiology*; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006261:Headache / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008881:Migraine Disorders / Q000150:complications / Q000503:physiopathology*; D010568:Peru / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult