Abstract
ObjectiveTo investigate headache treatment before and during pregnancy.BackgroundMost headaches in pregnancy are primary disorders. Headaches are likely to ameliorate during pregnancy, although they may also begin or worsen. Most headache medications should be avoided during pregnancy because of potential fetal risks. However, only scarce evidence on headache drug consumption during pregnancy is available.DesignATENA was a retrospective, self-administered questionnaire-based, cohort study on women in either pregnancy or who have just delivered and reporting headache before and/or during pregnancy.ResultsOut of 271 women in either pregnancy or who have just delivered, 100 (37%) reported headache before and/or during pregnancy and constituted our study sample. Before pregnancy, the attitude toward the use of symptomatic drugs was characterized by both a strong focus on their safety and the willingness to avoid possible dependence from them. Compared to the year before, pregnancy led to changes in behavior and therapeutic habits as shown by a higher proportion of patients looking for information about drugs (44/100 [44%] vs. 36/100 [36%]) and a lower proportion of those treating headache attacks (88/100 [88%] vs. 52/100 [52%]) and by a lower use of nonsteroidal anti-inflammatory drugs (68/100 [68%] vs. 5/100 [5%]) and a much higher use of paracetamol (33/100 [33%] vs. 95/100 [95%]).ConclusionsPregnancy changes how women self-treat their headache, and leads to search for information regarding drug safety, mostly due to the perception of fetal risk of drugs. Healthcare providers have to be ready to face particular needs of pregnant women with headache.
Highlights
Most headaches in pregnancy are primary disorders
We aimed to investigate headache before and/or during pregnancy in a cohort of women, focusing on its pharmacological treatment, in terms of attitude on drug use, need of information on medications, and perception of the possible risks to the fetus deriving from drug consumption
The questionnaire was constituted by seven main sections: personal information, pregnancy information, headache history, headache presentation and medications before and during pregnancy, attitude toward use of headache medications before and during pregnancy, perception of fetal risk of drugs and substances during pregnancy, and research of information on headache medications before and during pregnancy (Table 1)
Summary
Most headaches in pregnancy are primary disorders. Headaches are likely to ameliorate during pregnancy, they may begin or worsen. Most headache medications should be avoided during pregnancy because of potential fetal risks. Conclusions Pregnancy changes how women self-treat their headache, and leads to search for information regarding drug safety, mostly due to the perception of fetal risk of drugs. The consumption of medications, with proven or unknown teratogenic potential, to treat [9, 10] or prevent [11,12,13] headache attacks can result in fetal malformations. A meta-analysis recently confirmed the association between the prenatal paracetamol exposure and the increased risk of child asthma [17] In another meta-analysis which compared triptan-exposed women with the healthy controls during pregnancy, a significant increase in the rates of spontaneous abortions was found, while no increased risk of fetal malformations or prematurity was detected [18]
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