Migraine Patterns During Pregnancy and Postpartum: A Prospective Cross-Sectional Study
DOI:
https://doi.org/10.69980/ajpr.v28i5.535Keywords:
Migraine, Pregnancy, Postpartum, Triggers, Analgesics, Maternal outcomeAbstract
Background: Migraine is a common neurological disorder, particularly among women of reproductive age. Pregnancy and the postpartum period involve hormonal, physiological, and lifestyle changes that may influence the onset, frequency, and severity of migraine attacks. Understanding migraine patterns and management strategies in this population is essential for optimizing maternal and fetal outcomes. This study investigates the clinical features, triggers, and treatment approaches of migraine among pregnant and postpartum women attending a tertiary care hospital.
OBJECTIVES: To assess the frequency, severity, triggers, and treatment practices of migraine among pregnant and postpartum women attending a tertiary care hospital.
METHODS: A prospective cross-sectional observational study was conducted over a three-month period (April to June 2025) in the Department of Obstetrics and Gynaecology at Varun Arjun Medical College and Rohilkhand Hospital, Shahjahanpur. A total of 40 participants clinically diagnosed with migraine were enrolled. Data were collected using structured proformas and face-to-face interviews. Descriptive analysis was performed using frequency and percentage distribution for demographic, clinical, and treatment-related variables.
RESULTS: The 25–30 years age group was most common (n=18, 45%). Primigravida women accounted for 55% (n=22). Migraine episodes occurred most frequently in the postpartum period (n=14, 35%) and third trimester (n=12, 30%). Moderate severity was observed in 18 participants (45%), severe in 16 (40%), and mild in 6 (15%). Sleep deprivation was the most reported trigger (n=22, 55%), followed by emotional stress (n=19, 47.5%) and hormonal fluctuations (n=16, 40%). Paracetamol was used by 25 women (62.5%), non-pharmacological methods by 20 (50%), and triptans by 1 (2.5%). Preterm delivery was observed in 5 participants (12.5%), low birth weight in 3 (7.5%), and NICU admission in 2 (5%). No complications occurred in 30 cases (75%).
CONCLUSIONS: Migraine during pregnancy and postpartum is commonly moderate to severe and predominantly triggered by sleep and stress-related factors. Early recognition and tailored management can support better maternal and fetal outcomes.
References
1. Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):343–349.
2. David PS, Kling JM, Starling AJ. Migraine in pregnancy and lactation. Curr Neurol Neurosci Rep. 2014 Apr;14(4):439..
3. Kurth T, Gaziano JM, Cook NR, et al. Migraine and risk of cardiovascular disease in women. JAMA. 2006 Jul 19;296(3):283-91.
4. Negro A, Rocchietti March M, Fiorillo M, Martelletti P. Chronic migraine: current concepts and ongoing treatments. Eur Rev Med Pharmacol Sci. 2011;15(12):1401–1420.
5. Silberstein SD. Migraine and pregnancy. Neurol Clin. 1997 Feb;15(1):209-31. doi: 10.1016/s0733-8619(05)70305-4.
6. Sacco S, Ricci S, Degan D, Carolei A. Migraine in women: the role of hormones and their impact on vascular diseases. J Headache Pain. 2012 Apr;13(3):177-89. doi: 10.1007/s10194-012-0424-y.
7. Lackovic M, Jankovic M, Mihajlovic S, Milovanovic Z, Nikolic D. Exploring the Connection between Migraines and Pregnancy: The Impact of Physical Activity on Symptom Management. Medicina (Kaunas). 2023 Dec 27;60(1):49. doi: 10.3390/medicina60010049.
8. Nappi RE, Sances G, Detaddei S, Ornati A, Chiovato L, Polatti F. Hormonal management of migraine at menopause. Menopause Int. 2009 Jun;15(2):82-6.
9. Phillips K, Koonalintip P, Wakerley BR. Migraine and Pregnancy. Life. 2024;14(10):1224. doi:10.3390/life14101224.
10. Pavlovic JM, Buse DC, Sollars CM, Haut S, Lipton RB. Trigger factors and premonitory features of migraine attacks: summary of studies. Headache. 2014 Nov-Dec;54(10):1670-9.
11. Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013;40(5 Suppl 3):S1–S80.
12. Roberto G, Raschi E, Piccinni C, et al,. Adverse cardiovascular events associated with triptans and ergotamines for treatment of migraine: systematic review of observational studies. Cephalalgia. 2015 Feb;35(2):118-31.
13. MacGregor EA. Migraine in pregnancy and lactation. Neurol Sci. 2014 May;35 Suppl 1:61-4.
14. Goldstein LB, Bushnell CD, Adams RJ, et al; American Heart Association Stroke Council; Council on Cardiovascular Nursing; Council on Epidemiology and Prevention; Council for High Blood Pressure Research,; Council on Peripheral Vascular Disease, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011 Feb;42(2):517-84.
15. Facchinetti F, Sances G, Borella P, Genazzani AR, Nappi G. Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium. Headache. 1991 May;31(5):298-301.
16. Kardes G, Hadimli A, Ergenoglu AM. Determination of the Frequency of Migraine Attacks in Pregnant Women and the Ways They Cope with Headaches: A Cross-Sectional Study. Healthcare (Basel). 2023 Jul 20;11(14):2070.
17. Kvisvik EV, Stovner LJ, Helde G, et al. Headache and migraine during pregnancy and puerperium: the MIGRA-study. J Headache Pain. 2011 Aug;12(4):443-51.
18. Alharthi TS, Hakami F, Binshalhoub FH, et al. Headache Characteristics and Their Influencing Factors Among Pregnant Women in Saudi Arabia: A Survey Study. Cureus. 2023 Nov 24;15(11):e49345.
19. Granella F, Sances G, Pucci E, Nappi RE, Ghiotto N, Napp G. Migraine with aura and reproductive life events: a case control study. Cephalalgia. 2000 Oct;20(8):701-7.
20. Sacco S, Ricci S, Degan D, Carolei A. Migraine in women: the role of hormones and their impact on vascular diseases. J Headache Pain. 2012;13(3):177–189.
21. MacGregor EA. Migraine management during pregnancy and lactation. Expert Rev Neurother. 2004;4(3):459–470.
22. Nezvalová-Henriksen K, Spigset O, Nordeng H. Triptan exposure during pregnancy and the risk of major congenital malformations and adverse pregnancy outcomes: results from the Norwegian Mother and Child Cohort Study. Headache. 2010 Apr;50(4):563-75.
23. Verschoor M, van Dijk MM, Algra AM, et al. Safety of triptans during pregnancy: a population-based study. Neurology. 2020;95(7):e895–e906.
24. Facchinetti F, Allais G, Nappi RE, D'Amico R, Marozio L, Bertozzi L, Ornati A, Benedetto C. Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalalgia. 2009 Mar;29(3):286-92.
25. Bushnell CD, Miller R, Jin L, Peterson ED. Migraine and outcomes in pregnancy: a systematic review. Cephalalgia. 2021;41(5):539–551.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 American Journal of Psychiatric Rehabilitation
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License permitting all use, distribution, and reproduction in any medium, provided the work is properly cited.
