Association between migraine, migraine subtype, and adverse pregnancy outcomes: A systematic review and meta-analysis

IF 3.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-04-30 DOI:10.1111/aogs.15115

Anna Steen Hansen, Cecilie Holm Christiansen, Ane Lilleøre Rom, Nina Olsen Nathan, Marie Stampe Emborg, Line Rode, Hanne Kristine Hegaard

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Abstract

Introduction

Migraine is one of the most prevalent conditions worldwide. This systematic review aimed to evaluate the association between migraine, its subtypes, and adverse pregnancy outcomes.

Material and Methods

Eligible cohort and retrospective case–control studies were included from PubMed and Embase databases from their inception to May 2024. Adverse pregnancy outcomes of interest were preeclampsia, preterm birth, low birthweight, small for gestational age, and placental abruption. Study quality was assessed using the Newcastle-Ottawa Scale. Meta-analyses of the outcomes with their odds ratios (ORs) and adjusted ORs (aOR), including a 95% confidence interval (CI), were performed using RevMan. Outcomes were pooled using random effects models, with separate analyses for cohort and retrospective case–control studies. The protocol was registered with PROSPERO (no. CRD42023404759).

Results

This meta-analysis included 19 studies (11 cohort and 8 retrospective case–control) encompassing 1 420 690 deliveries. Significant associations were observed between migraine and increased risk of preeclampsia (cohort: aOR 1.28 [95% CI: 1.11–1.47], I² = 0%), (retrospective case–control: aOR 3.4 [95% CI: 1.81–6.4], I² = 83%) and preterm birth (cohort: aOR 1.30 [95% CI: 1.17–1.44], I² = 11%). The meta-analyses of adjusted data on low birthweight and small for gestational age were inconsistent with respect to statistical significance (cohort: aOR 1.27 [95% CI: 0.89–1.82], I² = 36% and cohort: aOR 1.07 [95% CI: 1.03–1.12], I² = 0%, respectively). In addition, migraine without aura (MO) (cohort: OR 1.62 [95% CI: 1.30–2.01], I² = 0%; retrospective case–control: aOR 4.91 [95% CI: 2.78–8.67], I² = 0%) and migraine with aura (MA) (cohort: OR 2.06 [95% CI: 1–4.27], I² = 29%) were significantly associated with the risk of preeclampsia. Similarly, MO (cohort: OR 1.28 [95% CI: 1.11–1.49], I² = 0%) and MA (cohort: OR 1.25 [95% CI: 1.07–1.47], I² = 0%) were associated with preterm birth risk.

Conclusions

Pregnant women with migraines have a higher risk of preeclampsia and preterm birth compared with those without migraines. Migraine could be associated with an increased risk of low birth weight and small for gestational age. Sub-analyses indicate an elevated risk of preeclampsia and preterm birth across migraine subtypes. Notably, no previous meta-analyses have differentiated between migraine subtypes. Additional studies are needed to strengthen these findings.

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偏头痛、偏头痛亚型和不良妊娠结局之间的关系：一项系统综述和荟萃分析。

简介：偏头痛是世界上最普遍的疾病之一。本系统综述旨在评估偏头痛及其亚型与不良妊娠结局之间的关系。材料和方法：从PubMed和Embase数据库开始到2024年5月，纳入了符合条件的队列和回顾性病例对照研究。不良妊娠结局包括先兆子痫、早产、低出生体重、小于胎龄和胎盘早剥。使用纽卡斯尔-渥太华量表评估研究质量。使用RevMan对结果及其优势比（or）和调整后的or （aOR）进行meta分析，包括95%可信区间（CI）。使用随机效应模型汇总结果，对队列研究和回顾性病例对照研究分别进行分析。该协议已在普洛斯彼罗（PROSPERO）注册。CRD42023404759)。结果：本荟萃分析包括19项研究（11项队列研究和8项回顾性病例对照研究），涵盖1420690例分娩。偏头痛与子痫前期风险增加（队列：aOR 1.28 [95% CI: 1.11-1.47], I2 = 0%）、（回顾性病例对照：aOR 3.4 [95% CI: 1.81-6.4], I2 = 83%）和早产（队列：aOR 1.30 [95% CI: 1.17-1.44], I2 = 11%）之间存在显著关联。调整后的低出生体重和小胎龄数据的meta分析在统计学意义上不一致（队列：aOR 1.27 [95% CI: 0.89-1.82], I2 = 36%，队列：aOR 1.07 [95% CI: 1.03-1.12], I2 = 0%）。此外，无先兆偏头痛（MO）(队列：OR 1.62 [95% CI: 1.30-2.01], I2 = 0%；回顾性病例对照：aOR 4.91 [95% CI: 2.78-8.67], I2 = 0%)和先兆偏头痛（队列：OR 2.06 [95% CI: 1-4.27], I2 = 29%）与先兆子痫的风险显著相关。同样，MO（队列：OR 1.28 [95% CI: 1.11-1.49], I2 = 0%）和MA（队列：OR 1.25 [95% CI: 1.07-1.47], I2 = 0%）与早产风险相关。结论：与没有偏头痛的孕妇相比，偏头痛孕妇有更高的先兆子痫和早产的风险。偏头痛可能与低出生体重和胎龄小的风险增加有关。亚分析表明，偏头痛亚型中先兆子痫和早产的风险升高。值得注意的是，之前没有荟萃分析区分偏头痛亚型。需要进一步的研究来加强这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Obstetricia et Gynecologica Scandinavica 医学-妇产科学

CiteScore

8.00

自引率

4.70%

发文量

180

审稿时长

3-6 weeks

期刊介绍： Published monthly, Acta Obstetricia et Gynecologica Scandinavica is an international journal dedicated to providing the very latest information on the results of both clinical, basic and translational research work related to all aspects of women’s health from around the globe. The journal regularly publishes commentaries, reviews, and original articles on a wide variety of topics including: gynecology, pregnancy, birth, female urology, gynecologic oncology, fertility and reproductive biology.