Abstract Details

Title Migraine and Maternal Vascular Complications Across Gestation: A Quantitative Evidence Synthesis

Topic Headache

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 15-010

Objective

To systematically review and meta-analyze the magnitude and risks of cardiovascular and cerebrovascular events (CCE) in pregnant women with versus without migraine.

Background

Pregnancy is characterised by a proinflammatory and prothrombotic state. Migraine - through mechanisms such as cortical spreading depression, endothelial dysfunction, or higher patent foramen ovale prevalence - may lead to adverse vascular events. This study analyzes all the published literature to quantify the odds of unfavourable CCE in pregnant women with versus without migraine.

Design/Methods

A PRISMA-compliant meta-analytic review - utilizing databases such as PubMed, Scopus, Web of Science, and grey literature sources - applied a comprehensive search strategy to identify all relevant publications. The Newcastle-Ottawa scale was used for quality assessment. Adjusted odds ratios (ORs) were pooled preferentially, using the random-effects model. The protocol was registered prospectively on PROSPERO (CRD42024607723).

Results

Out of 9115 screened studies, we identified 11 relevant observational cohorts, encompassing 93,289,589 pregnancies, with all scoring “good” on the AHRQ standards. The adjusted odds for stroke events were elevated by 15.63 times (95% CI: 9.54-25.61). Pregnant migraineurs displayed a trend towards more hemorrhagic stroke events (95% CI: 0.91-7.49), while ischemic stroke odds were significantly elevated (OR: 10.41, 95% CI: 3.15-34.39). Myocardial infarction odds were higher in pregnant migraineurs versus non-migraineurs by 96%. Interestingly, peripartum cardiomyopathy odds were increased by 2.68 times (95% CI: 1.73-4.14). A single study on 18,345,538 pregnancy records demonstrated a 223% elevated odds of venous thromboemboli/pulmonary emboli, independent of age or pre-eclampsia diagnosis in pregnant women with migraine versus without.

Conclusions

These findings highlight the need for heightened clinical surveillance, targeted cardiovascular and cerebrovascular risk counselling, and multidisciplinary management strategies for this vulnerable population. Future studies with exhaustive migraine subtyping and attack frequency detailing are warranted, alongside mechanistic research to uncover the underlying factors for the independent association of migraine with CCE in pregnancy.

Authors/Disclosures
Nsser Abdelall, MD (LSU Health Sciences - CALS Bldg) PRESENTER	Dr. Abdelall has nothing to disclose.
Mohamed Ibrahim A. Mohamed, MD	Mr. Mohamed has nothing to disclose.
Rana S. Abdelhafiz	Miss Abdelhafiz has nothing to disclose.
Michael Salib, MD	Dr. Salib has nothing to disclose.
Reem H. Ismail, MD	Dr. Ismail has nothing to disclose.
Nada M. Badawy, MBBS	Dr. Badawy has nothing to disclose.
Mona Nada, MD	Prof. Nada has nothing to disclose.

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