Placental abruption is a pregnancy
complication in which the placenta peels away from the inner wall of the uterus
before delivery. Studies suggest that hypertensive disorders, thrombophilia,
increased maternal age, use of drugs such as cocaine, smoking, and injury to
the abdomen may increase the risk of placental abruption.
Migraine, a common and severe debilitating headache and
placental abruption share several pathophysiological characteristics. Dr. Sixto
Sanchez from University hospital of San Martin in Peru and colleagues assessed
the risk of placental abruption in relation to maternal history of migraine,
before and during pregnancy in Peruvian women.
The study enrolled cases of 375 women with pregnancies
complicated by placental abruption, and controls of 368 women without any
abruption. For the study, women were asked if they had any physician-diagnosed
migraine. After that the subject's headaches and migraine were classified
according to a criteria established by the International Headache Society. To
calculate odds ratios (aOR) and 95% confidence intervals (CI) logistic
regression procedures were used to adjusted for confounders.
Research reports reveal that history of headache or
migraine was associated with an increased risk of placental abruption (aOR =
1.60; 95% CI 1.16-2.20). A lifetime history of migraine was associated with a
2.14-fold increased odds of placental abruption (aOR = 2.14; 95% CI 1.22-3.75).
The odds of placental abruption was 2.11 (95% CI 1.00-4.45) for migraine
without aura; and 1.59 (95% 0.70-3.62) for migraine with aura.
authors concluded, "Study adds placental abruption to a
growing list of pregnancy complications associated with maternal
headache/migraine disorders." Nevertheless, authors also feel the need for more
prospective cohort studies for rigorous evaluation to investigate the extent to
which migraines and/or its treatments are associated with the occurrence of
placental abruption. They
suggest that 'Preconception counseling, important for women with any medical
conditions including migraine, may provide opportunities for optimizing control
of migraine symptoms with the lowest effective doses of the lowest number of
medications; or if appropriate, with non-pharmacological treatment including
biofeedback-assisted relaxation, hydration, improved sleep hygiene and
reductions in occupational and home activities'.