Sleep, weight factors in migraines during pregnancy

Wow.  No wonder my pregnancies sucked. I was fat AND I couldn’t sleep.

From Medscape:

High BMI, Lack of Sleep Linked to Need for Migraine Treatment During Pregnancy

NEW YORK (Reuters Health) Dec 25 – A high pre-pregnancy body mass index (BMI) and a lack of sleep predict whether women will need migraine medications during pregnancy, new research shows.

An estimated 20%-80% of women report migraines during pregnancy, study co-author Dr. Katerina Nezvalova-Henriksen, of the University of Oslo, Norway, and colleagues write in the December issue of Cephalalgia.

“Many migraineurs may experience an exacerbation of their symptoms at the beginning of the first trimester," the team notes. “Consequently, these women may require pharmacotherapy during this period, which also corresponds to the most vulnerable period of fetal development."

To narrow down which women were likely to need migraine medications during pregnancy, Dr. Nezvalova-Henriksen and her colleagues analyzed the newest available data from the Norwegian Mother and Child Cohort Study. That effort is an observational, prospective cohort study of 60,435 pregnant women recruited between 1999 and 2006 and conducted by the Norwegian Institute of Public Health.

Overall, 3840 (5.7%) women reported having a migraine during the first 5 months of pregnancy. Of these, 2525 (72.6%) reported using migraine medications during pregnancy.

About 76% of women *****ported migraine both prior to and during pregnancy reported using a migraine agent during pregnancy, compared with 51.8% *****ported migraine during pregnancy only.

The most common migraine agents used included non-narcotic analgesics (54.1%) and triptans (25.4%).

After adjusting for sociodemographic factors and comorbidities, sleep duration <5 h (odds ratio, OR, 1.5), pre-pregnancy BMI > 25.0 kg/m squared (OR 1.3), and being on sick leave (OR 1.3) were associated with the use of migraine medications during pregnancy.

By contrast, women *****ported acute musculoskeletal pain of the back, neck, and/or shoulder were less likely to use migraine medications during pregnancy (OR 0.6).

When it came to particular types of migraine medications, young mothers and those who had more than child were less likely to use triptans, while those who stopped taking serotonin-selective reuptake inhibitors and beta-receptor agonists prescribed before pregnancy were more likely to use triptans.

“Many women need drug treatment for migraine during pregnancy, and the choice of pharmacotherapy during this period may be influenced by maternal sociodemographic factors and comorbidities," the authors conclude.

Cephalalgia 2009;29:1267-1276.