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Medical/Surgical/Diseases/Complications

Poster Session 2

(588) Characterizing migraine headaches in pregnancy

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: To evaluate the frequency and characteristics of headaches in pregnancy.

Study Design: This is a single-site, prospective observational study of pregnant patients evaluated for recurrent headaches during prenatal visits between 12/2020 and 9/2022. Patients were evaluated using standardized questions regarding their specific headache symptoms and medications used. Headaches were treated using a sequential medication algorithm, escalating therapy prior to referral to neurology. The frequency and characteristics of headaches across pregnancy as well as obstetric and neonatal outcomes were recorded. Statistical analyses included logistical regression and repeated-measures ANOVA tests. 

Results: During the study period, 963 pregnant patients were evaluated for recurrent headaches through 2956 clinic encounters. Of these, 342 (36.54%) patients were diagnosed with only tension-type headaches versus 594 (63.46%) with at least one migraine headache. Patients with tension headaches experienced consistent headache frequency across gestation whereas p</span>atients with migraine headaches experienced peak headache frequency in the second trimester (Table 1). Nausea, vomiting and photophobia were the most common symptoms associated with migraine headaches and all 3 decreased in frequency with advancing gestation.  Eighty four percent of patients achieved adequate symptom control without escalation of the treatment algorithm beyond treatment using Tylenol with caffeine (Table 1). Only 41 (6.9%) patients required referral to neurology for management of their headaches.   

Conclusion: Migraine headaches are more common in pregnancy when compared to recurrent tension-type headaches.  The majority of migraine headaches can be adequately controlled with a sequential medication algorithm, with only 6.9% requiring referral to neurology.