Abstract

Objective

This study aims to investigate pregnancy and perinatal outcomes in women with tension-type headache, migraine without aura and migraine with aura by comparing them to women without any headache disorders.

Study design

Prospective cohort study including singleton pregnancies attending the first trimester aneuploidy screening at the University Hospital of Modena, in Northern Italy, between June 2018 and December 2019.

Results

A total of 515 consecutive women were included and headache disorders were reported in 43.5% of them (224/515). Tension-type headache was diagnosed in 24.3% of the cases, while 14% suffered from migraine without aura and 5.2% from migraine with aura. Birthweight was significantly lower in women affected by migraine with aura respective to other groups, and a significantly higher rate of small for gestational age infants was found in tension-type headache (10.4%) and in migraine with aura (24.9%) groups respective to the others (p < 0.001). Moreover, the admission to the neonatal intensive care unit was significantly higher in all the headache groups (p = 0.012). Multivariate analysis showed that women presenting tension-type headache (OR 4.19, p = 0.004), migraine with aura (OR 5.37, p = 0.02), a uterine artery pulsatility index >90th centile (OR 3.66, p = 0.01), low multiple of the median (MoM) of Pregnancy-associated plasma protein-A (PAPP-A) (OR 0.48, p = 0.05) and high MoM of Inhibin-A (OR 3.24, p = 0.03) at first trimester, are independently associated with the delivery of small for gestational age infants when compared to women without headache disorders.

Conclusion

Migraine with aura and tension type headache expose women to an increased risk of delivering small for gestational age infants, in association with some utero-placenta markers evaluated at first trimester. These women with headache disorders have an additional indication to undergo first trimester aneuploidy screening and would possibly benefit from specific interventions.

中文翻译：

---

受不同类型头痛疾病影响的女性的围产期结局：一项前瞻性队列研究

摘要

客观的

本研究旨在通过将患有紧张型头痛、无先兆偏头痛和有先兆偏头痛的女性与没有任何头痛疾病的女性进行比较，调查妊娠和围产期结局。

学习规划

前瞻性队列研究，包括 2018 年 6 月至 2019 年 12 月在意大利北部摩德纳大学医院参加孕早期非整倍体筛查的单胎妊娠。

结果

共纳入 515 名连续女性，其中 43.5% (224/515) 报告了头痛疾病。24.3%的病例被诊断为紧张型头痛，14%为无先兆偏头痛，5.2%为有先兆偏头痛。与其他组相比，有先兆偏头痛影响的女性的出生体重显着降低，而在紧张型头痛（10.4%）和有先兆偏头痛（24.9%）组中，小于胎龄儿的比例显着高于其他组。其他人 (p < 0.001)。此外，所有头痛组的新生儿重症监护病房入院率显着增加（p = 0.012）。多变量分析显示，女性出现紧张型头痛（OR 4.19，p = 0.004），先兆偏头痛（OR 5.37，p = 0.02），子宫动脉搏动指数 >

结论

伴有先兆和紧张型头痛的偏头痛使女性面临更高的分娩小于胎龄儿的风险，这与在妊娠早期评估的一些子宫胎盘标志物有关。这些患有头痛疾病的女性还有一个额外的适应症，即需要接受孕早期非整倍体筛查，并且可能会从特定的干预措施中受益。