1 in 5 women are concerned migraine will worsen and/or affec
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In their observational study based on data from the American Registry for Migraine Research (ARMR), Ryotaro Ishii and colleagues found that women with chronic migraine avoided pregnancy because they believe their migraines will worsen during pregnancy, make their pregnancy difficult, and negatively affect their babies. Their findings were published in Mayo Clinic Proceedings.

Migraine is a leading cause of disability worldwide, and according to Ishii and colleagues, is particularly burdensome for women. Not only does migraine affect quality of life during an actual episode, the condition also creates anxiety concerning when the next attack will hit, and how it will affect future plans and activities, such as pregnancy. The participants in the study were women with chronic migraine who answered an ARMR questionnaire containing family planning questions in the period. The study included 607 questionnaire respondents. These women had a mean age of 45.3 years and were mostly white (92.3%) with graduate degrees (61;8%). Half (50.4%) worked full-time, and about two-thirds (65.2%) were either married or living with a partner.

Of the women in the study, 19.9% responded that migraine either somewhat (8.4%) or significantly (11.5%) resulted in a decision not to get pregnant. While these women were younger (mean age 37.5 years) than women who reported that migraine had no impact on pregnancy decision making, there was no significant difference between the two groups regarding race, income, employment status, or marital status.

Ishii and colleagues also found that the compared to the women who did not avoid pregnancy, the avoid pregnancy group had fewer children (0.8 versus 1.5), were more likely to have chronic migraine ([81.8% versus 70.2%), and menstrually-associated migraine (4.1% versus 1.0%).

When asked how they thought migraine would impact pregnancy, more than half answered:

-Migraines would get worse during or just after pregnancy (72.5%)
-Disability caused by migraine would make the pregnancy difficult (68.0%)
-Disability from migraine makes raising children difficult (82.6%)
-Migraine medications could negatively affect child development (76.0%)
-They could pass on genes that could cause their babies to have an elevated risk of having migraine (72.7%)
-Additionally, one in seven of these women (14%) were concerned migraine could cause their babies to have abnormalities at birth.

The authors pointed out that the medical literature shows that migraine headaches usually improve during pregnancy, with about one-half to three- fourths of those with migraine having a marked improvement. Yet, in their study a significant percentage of women believe migraine will worsen during pregnancy and make it more difficult.

Source:https://www.mayoclinicproceedings.org/article/S0025-6196(20)30820-X/fulltext, Physician's weekly
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