birth defects

6 June 2019

Does Migraine Increase Pregnancy Risks?

A study out of Denmark, published last month in the journal Headache, is raising serious concerns about the link between migraine and certain pregnancy risks. How can mothers with migraine give their babies the best possible opportunities for good health?

In the study, researchers used population registries and identified 22,841 women with migraine who became pregnant, compared with 228,324 pregnancies where there was no migraine. They then identified several areas of increased risk for the women with migraine, including:

pregnancy associated hypertension disorders
miscarriage
low birth weight
preterm birth
birth defects

There was also a higher risk of several complications after birth, such as febrile seizures.

The most concerning issue was that the increased risk seemed to be there whether or not migraine was treated – suggesting to the researchers that it was migraine disease itself that increased the risks in pregnancy, not the treatment or lack of treatment.

Although there are some weaknesses with this study, it does seem to confirm other studies that also indicate risks in pregnancy due to migraine. It’s difficult to tell exactly how medications come into play, but the researchers seem to think that medications are not explaining the risk.

At first, this may sound like information that you can’t use. After all – if there’s no improvement with treatment or without treatment, who cares? But several things need to be kept in mind.

This study only found some associations with migraine, and further study will be needed to confirm. This is not to say that treatment is will not help you and your baby during pregnancy.
Anytime there is an indication of increased risk, what can you do? You can decrease your risk in other areas. If there is a risk of hypertension, there are ways to lower your risk.
Just because there is an increased risk does not mean it’s a high risk. This is very important to remember – the risk from migraine is still low.
Pay attention to your own symptoms and talk to your doctor about them. A registry based study like this one relies a lot on minimal information collected after the fact. There are a lot of issues that may cause headaches, migraine, and changes in your symptoms. It’s not “just normal” in pregnancy.

For a summary of migraine changes during pregnancy, you may find this infographic helpful: Migraine During and After Pregnancy

Also, for a discussion of dealing with migraine and headache during pregnancy, and assessing medication risks, read The Myth-Busting Guide to Migraines and Pregnancy

And may your baby be healthy – and may you be healthier than ever – in the months ahead!

To read the whole study, or the abstract, see Pregnancy, Birth, Neonatal, and Postnatal Neurological Outcomes After Pregnancy With Migraine

19 March 2011

Topamax – Kidney Stones and Birth Defects?

James Medications, News 0

One of today’s preventative drugs for migraine Topamax (topiramate) has come under fire lately as the medical community expresses concern about some of its possible side effects.

Coming first in December, a study out of the University of Texas brought up the issue of kidney stones (nephrolithiasis). Patients on topiramate for two years were tested. 10.7% of them had kidney stones with outward symptoms. However, among patients with no history of kidney stones, the CT scan showed that 20% had kidney stones with no symptoms after two years of taking topiramate!

What does that mean? It means that, if you take Topamax for a couple of years, you have a very good chance of developing kidney stones. (read Nephrolithiasis in topiramate users.)

Then, just this month, the FDA in the United States issued a warning that topiramate could cause development of cleft lip and/or cleft palate in newborns. Taking Topamax could double your risk – still a small risk, but quite a jump. This is particularly a concern in the first trimester, but the dangers thereafter are not well understood. We do know that topiramate passes into breast milk.

Another reason for pregnant women to carefully consider the risks before taking Topamax during pregnancy.

Topamax has helped many migraine patients. There’s a reason why it’s frequently prescribed. But we need to remember that it does have risks. Many patients stop taking it because of side effects (and migraine patients may have more Topamax side effects than everyone else). But the fact of the matter is, some side effects are not known right away. There are other treatments that should be tried first, including both drug and non-drug options.

via Warnings about Topamax (topiramate)

17 February 2010

How Dangerous are Migraine Drugs during Pregnancy?

James Medications 0

In the past, doctors have encouraged women to avoid certain drugs, including triptans, Divalproex sodium, aspirin and ibuprofen, during pregnancy. One of the reasons is because of the possibility of birth defects with certain medications.

Sometimes these concerns are well grounded in research. But quite often they’re more a result of a lack of research. We’re just not sure what such-and-such a drug will do to the baby.

A new study of 70,000 women set out to find a link between triptans in particular and birth defects. 1535 of the women had used sumatriptan (Imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), or eletriptan (Relpax) during pregnancy. The answer – there doesn’t seem to be a link. Babies born to women taking triptans during pregnancy had no more risk of birth defects than did the general population.

So it seems that for now triptans are a clear choice for pregnant women, though the researchers caution that other independent studies are needed. However, the researchers did find a few things that were disturbing.

Caution still needed…

The researchers reported a "slight increase" in the risk of excessive bleeding after delivery. More specifically, the women taking triptans were more likely to develop atonic uterus, a condition where the uterus doesn’t contract properly after delivery – leading to excessive bleeding.

It was also found that the women taking triptans were more likely to lose significant blood during labour and delivery, and more likely to develop pre-eclampsia or eclampsia. There was also a chance of increased vomiting during pregnancy, and an increased chance of being folate deficient (low in folic acid).

Now after seeing the big long list you may be concerned. But we’re not talking about a high risk here – though it is a risk that is significant enough to be mentioned.

And remember, migraine itself has its own risks. Migraine may increase a pregnant woman’s risk of stroke and heart disease, for example.

So every choice has its risks. During pregnancy, it’s important to take the time to evaluate your migraine symptoms, and find treatment. Make sure your doctor takes the time to deal with this important aspect of your life – it’s easy to try to ignore it with so many other things going on!

Heads up from: Somebody Heal Me