title: Migraine, cardiovascular disease, and stroke during pregnancy: systematic review of the literature.
abstract: OBJECTIVE
  The objective of this article is to review the literature relating migraine, cardiovascular disease, and stroke during pregnancy in order to better define the relationship between migraines and vascular disease.
  
  
  METHODS
  We conducted a systematic review of the literature using Medline and Cochrane Review with the following search terms: migraine AND pregnancy and vascular disease OR myocardial infarction OR heart disease OR stroke OR cerebrovascular disease OR hypertension in pregnancy. We also reviewed the bibliographies of papers identified in this search to obtain additional relevant studies.
  
  
  RESULTS
  Of the 219 papers obtained with the primary search, we found 17 that were topically relevant. Altogether, there is an increased risk both of gestational hypertension (OR range from 1.23 to 1.68) and preeclampsia (OR range 1.08 to 3.5) in migraineurs compared to nonmigraineurs. In addition, there is an association between an increased risk of ischemic stroke in pregnancy (OR range 7.9 to 30.7), particularly with active migraine. There is also an association between migraine and increased risk of acute myocardial infarction and heart disease (OR 4.9; 95% CI 1.7, 14.2), and thromboembolic events during pregnancy (deep venous thrombosis OR 2.4; 95% CI 1.3, 4.2 and pulmonary embolus OR 3.1; 95% CI 1.7, 5.6).
  
  
  CONCLUSIONS
  In this review, we summarized the association between migraine and risk of vascular disease during pregnancy, based on the available literature. Given the limited amount of data, more research on these associations is needed to determine which women with migraine may be at risk while pregnant.
authors.affiliation: Wake Forest School of Medicine, Department of Neurology, NC, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Wabnitz
authors.affiliation: Wake Forest School of Medicine, Department of Neurology, NC, USA cbushnel@wakehealth.edu.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Bushnell
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008881:Migraine Disorders / Q000150:complications*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D020521:Stroke / Q000453:epidemiology*
keywords: Migraine; hypertensive disorders in pregnancy; migraine with aura; pregnancy; stroke