Migraine during pregnancy: Is it more than a headache?

Stephen A. Contag, Heather L. Mertz, Cheryl D. Bushnell

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations


Migraine headaches have a female predominance with a peak in prevalence in the third and fourth decades of life. Women of reproductive age are liable to develop their first migraine while pregnant or exhibit changes in the character, frequency or severity of their headaches during pregnancy and the puerperium. The purpose of this Review is to examine the pathophysiology underlying the development of migraine headaches and the association of this pathophysiology with pregnancy-related complications. We also discuss the diagnosis and management of migraine headaches that precede pregnancy or develop de novo during pregnancy, placing an emphasis on the distinction between primary migraine headache and headache secondary to pre-eclampsiaa relatively frequent complication of pregnancy and the puerperium. We present the case of a woman with a history of migraine headaches before pregnancy, whose symptoms progressed during pregnancy in part because of increasing exposure to narcotic medications. We also review the options for migraine evaluation and treatment, and provide an overview of the risks associated with the different treatment options.

Original languageEnglish (US)
Pages (from-to)449-456
Number of pages8
JournalNature Reviews Neurology
Issue number8
StatePublished - Aug 1 2009


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