Migraine and its Association with Stroke in Pregnancy: A National Examination
Publication: Journal of Women's Health
Volume 33, Issue Number 11
Abstract
Background: Migraine prevalence has been estimated to be as high as 25% during reproductive years. Despite this, and the known significantly lower odds of acute stroke being correctly diagnosed among women versus men, little is known about the migraine–stroke connection in this vulnerable population. Our study seeks to provide a consolidated examination of cerebrovascular and obstetric complications of migraines in pregnant women and to evaluate the role of concurrent comorbidities.
Methods: We utilized the 2016–2020 Healthcare Cost and Utilization Project’s National Inpatient Sample with the International Classification of Diseases, 10th Revision diagnostic codes to compare pregnant patients with migraines with those without migraines. Multivariable logistic regression was used to examine the incidence of subtypes of stroke while controlling for confounding variables.
Results: Overall, 19,825,525 pregnant patients were evaluated; 219,175 (1.1%) had a concomitant diagnosis of migraine. Pregnant patients with migraines were more likely to suffer ischemic (0.1% versus 0.0%) or hemorrhagic stroke (0.3% versus 0.1%). On multivariate analysis, acute ischemic stroke was most strongly associated with migraine with aura (odds ratio [OR], 23.26; 95% confidence interval [CI], 18.46–29.31), followed by migraine without aura (OR, 8.15; 95% CI, 4.79–13.88).
Conclusions: Pregnant women with migraine are at a significantly increased risk for both ischemic and hemorrhagic stroke. Pregnant women with migraines should be cautioned that they may be at an increased risk of stroke, particularly if they are experiencing an aura, and encouraged to contact their medical providers to rule out neurological complications.
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Information & Authors
Information
Published In
Journal of Women's Health
Volume 33 • Issue Number 11 • November 2024
Pages: 1476 - 1481
PubMed: 39435508
Copyright
Copyright 2024, Mary Ann Liebert, Inc., publishers.
History
Published online: 4 November 2024
Published in print: November 2024
Published ahead of print: 22 October 2024
Topics
Data Availability
The National Inpatient Sample (NIS) is a publicly available database. All data used in this study are available upon reasonable request with evidence of completion of onboarding process as per Healthcare Cost and Utilization Project (HCUP).
Authors
Authors’ Contributions
F.A.M., M.R., and B.N. conceived the project and methodology. S.V. completed the statistical analysis and contributed to data analysis. B.N. and M.R. performed literature review, interpreted the analysis, and wrote the article. K.C. and E.F. contributed to data analysis and article writing. C.M., G.K., S.K.R., A.L.C., J.L., and C.D.G. read, reviewed, and provided critical revisions for the final article.
Author Disclosure Statement
No competing financial interests exist.
Funding Information
No funding was received for this article.
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