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. 2011 Aug;12(4):443-51.
doi: 10.1007/s10194-011-0329-1. Epub 2011 Mar 26.

Headache and migraine during pregnancy and puerperium: the MIGRA-study

Elisabeth Volden Kvisvik  1 , Lars Jacob Stovner, Grethe Helde, Gunnar Bovim, Mattias Linde
Affiliations

Headache and migraine during pregnancy and puerperium: the MIGRA-study

Elisabeth Volden Kvisvik et al. J Headache Pain. 2011 Aug.

Abstract

There is little prospectively gathered data on the course of headaches during pregnancy and postpartum, and the influence of breastfeeding is unclear. This is a large, prospective study, which invited all pregnant women in the catchment area during a defined period. All participants (n = 2,126) filled in questionnaires concerning headache. Among these, a total of 208 women with migraine according to the International Headache Society criteria also filled in detailed headache diaries during pregnancy and the puerperal period. Freedom from earlier headaches during pregnancy was significantly more common than new onset of headache during pregnancy (p < 0.001). This was not influenced by prior use of oral contraceptives. According to the diaries, there was a gradual decrease during pregnancy in the frequency of all headaches and of self-considered migraine. There was also a significant decrease in the duration of headaches (p < 0.001) during pregnancy compared to before. Earlier parity did not influence the course. Apart from a significant increase during the first week postpartum (p < 0.01), the overall occurrence of headaches during puerperium did not differ from the pregnancy period. Compared to pregnancy, there was a postpartum increase in the mean intensity (p < 0.01) and duration (p = 0.050) of headaches, as well as in the mean number of analgesics used (p < 0.001). Breastfeeding did not influence the occurrence of headaches postpartum. These data are of practical value for informing pregnant migraineurs about the typical clinical prospects and for giving advice on breastfeeding.

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Figures

Fig. 1
Fig. 1
a Flow of participants through the different steps of the questionnaire survey b Flow of participants through the different steps of the diary survey
Fig. 2
Fig. 2
Variation of the mean frequency of all headaches combined (upper graph) and self-considered migraine (lower graph) during pregnancy (second half) and puerperium among migraineurs with complete diaries (n = 66)
Fig. 3
Fig. 3
Variation in point-prevalence (daily %) of all headaches combined (black bars) and self-considered migraine (white bars) during the period from 2 weeks before delivery until 2 weeks after delivery among migraineurs with complete diaries (n = 66)
Fig. 4
Fig. 4
Distribution of breastfeeding (n = 607) and non-breastfeeding (n = 56) women among different categories of frequency of any headache (number of attacks during the first 8 weeks) of the puerperium
Fig. 5
Fig. 5
Course of overall headache (calendars) during the puerperium for breastfeeding (white circles, n = 149) and non-breastfeeding (black triangles, n = 9) migraineurs
Fig. 6
Fig. 6
Course of self-considered migraine (calendars) during the puerperium for breastfeeding (white circles, n = 149) and non-breastfeeding (black triangles, n = 9) migraineurs
Fig. 7
Fig. 7
Distribution of breastfeeding (n = 611) and non-breastfeeding (n = 55) women among different categories (questionnaire data) of duration of headaches in general during the puerperium
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