title: Delivery Outcomes of Patients with Acute Migraine in Pregnancy: A Retrospective Study.
abstract: OBJECTIVE
  To describe labor and delivery outcomes in pregnant patients presenting to the hospital setting with an acute severe migraine headache attack earlier in the same gestation.
  
  
  METHODS
  We retrospectively reviewed pregnancy and delivery records from a database of consecutive inpatient neurology consultations for acute headache in pregnant women over a 5 year period.
  
  
  RESULTS
  We identified 86 pregnant women with acute migraine. The mean age was 29.3 (±6.4) years. Nearly half had migraine with aura (35/86 [40.7%]), 12.8% (12/86) had chronic migraine, and 31.4% (27/86) presented in status migrainosus. Complication rates included 54.7%([41/75], 95% CI 29.87, 52.13) for at least one adverse outcome, 28.0% ([21/75], 95% CI 11.78, 30.22) for preterm delivery, 21.3% ([16/75], 95% CI 7.7, 24.3) for preeclampsia, 30.6% ([23/75] 95% CI 13.48, 32.52) for cesarean delivery, and 18.7% ([14/75] 95% CI 6.15, 21.85) for low birthweight.
  
  
  CONCLUSIONS
  Pregnant women seeking treatment for acute migraine headache experienced a higher rate of preterm delivery, preeclampsia, and low birthweight but a lower rate of cesarean delivery than the local and general populations. More than half (54.7% [41/75] 95% CI 29.87, 52.13) of the study patients experienced some type of adverse birth outcome, suggesting that pregnancies in migraine patients presenting to an acute care setting may benefit from more intense surveillance.
authors.affiliation: Department of Obstetrics & Gynecology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Tracy B
authors.initials: TB
authors.lastname: Grossman
authors.affiliation: Department of Neurology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Robbins
authors.affiliation: Department of Obstetrics & Gynecology, New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Shravya
authors.initials: S
authors.lastname: Govindappagari
authors.affiliation: Department of Obstetrics & Gynecology, New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Ashlesha K
authors.initials: AK
authors.lastname: Dayal
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D005260:Female; D005313:Fetal Death; D006801:Humans; D007230:Infant, Low Birth Weight; D008881:Migraine Disorders / Q000150:complications* / Q000175:diagnosis; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
keywords: birth outcome; migraine; pregnancy