Migraine and Pregnancy: Understanding the Risks
Posted on May 01 2025,
Migraine and Pregnancy: Understanding the Risks
Findings from a meta-analysis of 19 studies involving over 1.4 million pregnancies
Overview
Migraine is a common neurological condition that affects approximately 20% of pregnant women. Recent research shows that women with migraine may face a higher risk of certain pregnancy complications. This article summarizes the key findings from a systematic review and meta-analysis that examined data from 19 studies with over 1.4 million pregnancies to provide strong evidence about the connection between migraine and pregnancy outcomes.
Quick Summary of Findings
- Women with migraine have a higher risk of developing preeclampsia during pregnancy
- Migraine is associated with an increased risk of preterm birth
- Both types of migraine (with and without aura) are linked to these risks
- There may also be links to low birthweight and small for gestational age babies, but the evidence is less conclusive
- Understanding these risks can help with monitoring and managing pregnancies in women with migraine
Key Findings: Preeclampsia Risk
The research shows a significant association between migraine and the development of preeclampsia during pregnancy. This finding was consistent across multiple studies.
What is preeclampsia?
Preeclampsia is a serious pregnancy complication characterized by high blood pressure (≥140/90 mmHg) and signs of damage to other organ systems, most often the liver and kidneys. It typically occurs after 20 weeks of pregnancy and is usually detected through protein in the urine (proteinuria). If left untreated, preeclampsia can lead to serious, even fatal, complications for both mother and fetus.
28%
Increased Risk
Women with migraine have approximately 28% higher odds of developing preeclampsia compared to women without migraine.
Absolute risk: Preeclampsia affects about 2-8% of pregnancies generally. For women with migraine, this increases to approximately 2.6-10.2%.
62%
MO-Related Risk
Women with migraine without aura have about 62% higher odds of developing preeclampsia.
Absolute risk: With migraine without aura, preeclampsia risk increases to approximately 3.2-13%.
106%
MA-Related Risk
Women with migraine with aura have approximately double (106% higher) the odds of developing preeclampsia.
Absolute risk: With migraine with aura, preeclampsia risk increases to approximately 4.1-16.5%.
Note about the statistics
The overall 28% increased risk comes from larger studies examining migraine as a whole, while the subtype-specific risks (62% and 106%) come from a smaller subset of studies that analyzed migraine subtypes separately. The different percentages reflect different study groupings and statistical approaches, not a mathematical inconsistency.
"Pregnant women with migraine have a higher risk of preeclampsia compared with those without migraine. Both migraine subtypes (with and without aura) were significantly associated with the risk of preeclampsia."
Key Findings: Preterm Birth Risk
The research also found a significant association between migraine and preterm birth. Women with migraine were more likely to deliver their babies before full term.
What is preterm birth?
Preterm birth is defined as a baby born alive before 37 weeks of pregnancy are completed. A normal pregnancy lasts about 40 weeks. Preterm babies may face various health challenges because they've had less time to develop in the womb, including breathing problems, feeding difficulties, and an increased risk of developmental issues.
30%
Increased Risk
Women with migraine have approximately 30% higher odds of experiencing preterm birth compared to women without migraine.
Absolute risk: Preterm birth affects about 8-10% of pregnancies generally. For women with migraine, this increases to approximately 10.4-13%.
28%
MO-Related Risk
Women with migraine without aura have about 28% higher odds of experiencing preterm birth.
Absolute risk: With migraine without aura, preterm birth risk increases to approximately 10.2-12.8%.
25%
MA-Related Risk
Women with migraine with aura have about 25% higher odds of experiencing preterm birth.
Absolute risk: With migraine with aura, preterm birth risk increases to approximately 10-12.5%.
"Similarly, migraine without aura and migraine with aura were associated with preterm birth risk. These findings suggest that monitoring pregnant women with migraine, regardless of subtype, may be beneficial for identifying potential complications earlier."
Other Potential Risks
The research also looked at other pregnancy outcomes, with mixed results:
Additional Findings
Low Birthweight Possible Link
Small for Gestational Age Slight Increase (7%)
Placental Abruption Limited Evidence
Understanding these conditions
- Low Birthweight: Babies weighing less than 2,500 grams (5.5 pounds) at birth, regardless of gestational age. Affects approximately 7% of births, may increase to about 8.9% for women with migraine.
- Small for Gestational Age (SGA): Babies whose weight falls below the 10th percentile for their gestational age, meaning they are smaller than 90% of babies at the same stage of pregnancy. Affects about 10% of pregnancies by definition, with a marginal increase to around 10.7% for women with migraine.
- Placental Abruption: A serious condition where the placenta partially or completely separates from the inner wall of the uterus before delivery, which can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother. Affects about 1% of pregnancies, with preliminary data suggesting a potential increase to around 2.1% for women with migraine.
Why Do These Connections Exist?
Researchers believe there may be shared underlying mechanisms between migraine and pregnancy complications:
Possible Biological Mechanisms
- Blood Vessel Function: Both migraine and conditions like preeclampsia involve problems with blood vessels and their lining (endothelial dysfunction)
- Inflammation: Higher levels of inflammation markers are found in people with migraine and in those with pregnancy complications
- Platelet Activation: Increased platelet activity (cells involved in blood clotting) is seen in both migraine and pregnancy complications
- Cardiovascular Factors: Migraine, particularly with aura, is linked to cardiovascular issues that may also affect pregnancy
"Migraine and its subtypes may share overlapping pathophysiological features with certain adverse pregnancy outcomes such as preeclampsia and preterm birth. Additionally, migraine has been linked to endothelial dysfunction, a key component of preeclampsia pathophysiology."
What This Means For You
If you have migraine and are pregnant or planning to become pregnant, these findings shouldn't cause alarm but can help inform your care:
Practical Implications
- Women with migraine may benefit from closer monitoring during pregnancy, especially for signs of preeclampsia
- Discuss your migraine history with your healthcare provider, including whether you experience aura
- Be aware of preeclampsia warning signs (severe headaches, vision changes, upper abdominal pain, sudden swelling, etc.)
- Attend all prenatal appointments to monitor blood pressure and other indicators
- The increased risks, while significant, are still relatively modest for most women
- Many women with migraine experience improvement in their symptoms during pregnancy, particularly by the third trimester
"The findings emphasize that more studies are still needed, particularly regarding the relationship between migraine subtypes and all pregnancy outcomes. This research provides valuable information for healthcare providers to consider when caring for pregnant women with migraine."
Based on: Hansen AS, Christiansen CH, Rom AL, Nathan NO, Emborg MS, Rode L, Hegaard HK. (2025). Association between migraine, migraine subtype, and adverse pregnancy outcomes: A systematic review and meta-analysis. Acta Obstetricia et Gynecologica Scandinavica, 00:1-15. DOI: 10.1111/aogs.15115
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