Facchinetti F, Allais G, Nappi R E, D'Amico R, Marozio L, Bertozzi L, Ornati A, Benedetto C
Unit of Psychobiology of Reproduction-UCADH, Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy.
Cephalalgia. 2009 Mar;29(3):286-92. doi: 10.1111/j.1468-2982.2008.01704.x.
The aim was to assess whether women suffering from migraine are at higher risk of developing hypertensive disorders in pregnancy. In a prospective cohort study, performed at antenatal clinics in three maternity units in Northern Italy, 702 normotensive women with singleton pregnancy at 11-16 weeks' gestation were enrolled. Women with a history of hypertensive disorders in pregnancy or presenting chronic hypertension were excluded. The presence of migraine was investigated according to International Headache Society criteria. The main outcome measure was the onset of hypertension in pregnancy, defined as the occurrence of either gestational hypertension or preeclampsia. Two hundred and seventy women (38.5%) were diagnosed with migraine. The majority (68.1%) suffered from migraine without aura. The risk of developing hypertensive disorders in pregnancy was higher in migraineurs (9.1%) compared with non-migraineurs (3.1%) [odds ratio (OR) adjusted for age, family history of hypertension and smoking 2.85, 95% confidence interval (CI) 1.40, 5.81]. Women with migraine also showed a trend to increased risk for low birth weight infants with respect to women without migraine (OR 1.97, 95% CI 0.98, 3.98). Women with migraine are to be considered at increased risk of developing hypertensive disorders in pregnancy. The diagnosis of primary headaches should be taken into account at antenatal examination.
目的是评估患偏头痛的女性在孕期发生高血压疾病的风险是否更高。在意大利北部三个产科单位的产前诊所进行的一项前瞻性队列研究中，纳入了702名妊娠11 - 16周的单胎妊娠血压正常的女性。排除有孕期高血压疾病史或患有慢性高血压的女性。根据国际头痛协会标准调查偏头痛的存在情况。主要结局指标是孕期高血压的发生，定义为妊娠期高血压或先兆子痫的出现。270名女性（38.5%）被诊断为偏头痛。大多数（68.1%）患有无先兆偏头痛。与非偏头痛患者（3.1%）相比，偏头痛患者孕期发生高血压疾病的风险更高[校正年龄､高血压家族史和吸烟因素后的优势比（OR）为2.85，95%置信区间（CI）为1.40，5.81]。与无偏头痛的女性相比，有偏头痛的女性生出低体重儿的风险也有增加的趋势（OR 1.97，95% CI 0.98，3.98）。应考虑到患偏头痛的女性在孕期发生高血压疾病的风险增加。产前检查时应考虑原发性头痛的诊断。
