title: Postpartum migraines: a long-term prospective study.
abstract: OBJECTIVE
  There are many reports regarding the course of migraines during pregnancy. However, the prevalence and characteristics of migraines during the postpartum period have not been adequately investigated. We prospectively investigated the patients suffering from migraines over a long postpartum period in an obstetrics department in Japan.
  
  
  METHODS
  We investigated the course of migraines experienced during the postpartum period by patients in a postnatal ward. The patients were surveyed during the first postpartum week and 1, 3, 6 and 12 months after delivery. The patients were provided a headache diary to assess medication use and migraine attack frequency, severity (the faces pain scale) and duration.
  
  
  RESULTS
  The migraine remission rate was 63%, 83% and 85% during the first, second and third trimesters, respectively. No patient experienced a worsening of headaches during pregnancy. Headache recurrence during the first month after delivery was more frequent in the patients >30 years of age than in those ≤30 years of age (p<0.05). The percentage of women experiencing recurrence at 1, 3, 6 and 12 months after delivery was 63%, 75%, 78% (n=60) and 87.5% (n=40), respectively. In breastfeeding patients, the rates were 50%, 65.8%, 71.1% and 91.7% and in bottle feeding patients, the rates were 86.4%, 90.9%, 95.5% and 81.3%, respectively.
  
  
  CONCLUSIONS
  We found that 85% of the patients with migraines experience remission during pregnancy and that more than 50% experience recurrence during the first month after delivery. Until six months after delivery, breastfeeding is associated with a lower recurrence rate than bottle feeding.
authors.affiliation: Department of Neurology, Dokkyo Medical University, Japan.
authors.forename: Eisei
authors.initials: E
authors.lastname: Hoshiyama
authors.forename: Muneto
authors.initials: M
authors.lastname: Tatsumoto
authors.forename: Hisatake
authors.initials: H
authors.lastname: Iwanami
authors.forename: Akihiro
authors.initials: A
authors.lastname: Saisu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Inaba
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008881:Migraine Disorders / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology; D010147:Pain Measurement; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D012008:Recurrence; D055815:Young Adult