Perinatal outcomes in women affected by different types of h
Pregnant women who experience migraines with aura – and also the far more common tension-type headache – are at increased risk for giving birth to small-for-gestational-age babies, according to results from an observational study.

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

This is a prospective cohort study including singleton pregnancies attending the first-trimester aneuploidy screening. A total of 515 consecutive women were included and headache disorders were reported in 43.5% of them. 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 and in migraine with aura groups respective to the others.

- Moreover, the admission to the neonatal intensive care unit was significantly higher in all the headache groups.

- Multivariate analysis showed that women presenting tension-type headache, migraine with aura, a uterine artery pulsatility index >90th centile, low multiple of the median (MoM) of Pregnancy-associated plasma protein-A (PAPP-A), and high MoM of Inhibin-A at the first trimester, are independently associated with the delivery of small for gestational age infants when compared to women without headache disorders.

Conclusively, migraines with aura and tension-type headaches expose women to an increased risk of delivering small for gestational age infants, in association with some utero-placenta markers evaluated at the first trimester.