Lifetime prevalence and correlates of migraine among women in a pacific northwest pregnancy cohort study.

Abstract

Migraine is a common neurological disorder, ranked among the world's leading causes of years lived with disability by the World Health Organization. The burden of migraine is highest in women of reproductive age. We characterized the prevalence, symptoms, and correlates of migraine and other headaches among 500 women enrolled in a pregnancy cohort study. Migraine diagnoses (eg, definitive migraine and probable migraine) were based on the International Classification of Headache Disorders-II criteria. Headache-related disability, before and during early pregnancy, was determined using the Migraine Disability Assessment questionnaire. Logistic regression models were used to estimate adjusted odds ratios and 95% confidence intervals. The lifetime prevalence of definitive migraine was 20.0% (95% confidence interval 16.6-23.8%). When probable migraine was included, the lifetime prevalence of any migraine (definitive migraine plus probable migraine) increased to 29.8% (95% confidence interval 25.9-34.0%). An additional 16.6% (95% confidence interval 13.5-20.2%) of women in the cohort were classified as having non-migraine headaches. Over 26% of migraineurs experienced moderate or severe headache-related disability during early pregnancy. Migraine headaches were associated with a family history of headache or migraine (odds ratio = 3.47; 95% confidence interval 2.14-5.63), childhood car sickness (odds ratio = 8.02; 95% confidence interval 4.49-14.35), pre-pregnancy obesity status (odds ratio = 3.83; 95% confidence interval 1.77-8.26), and a high frequency of fatigue (odds ratio = 2.01; 95% confidence interval 1.09-3.70). Migraine- and headache-related disability are prevalent conditions among pregnant women. Diagnosing and treating migraine and headaches during pregnancy are essential.