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Clinicians should encourage the use of safe analgesics in pregnant women; most of the pregnant women stopped taking analgesics or switched to paracetamol for headache or migraine.
A migraine headache is a type of headache that is often accompanied by nausea and sensitivity to light and sound. During pregnancy, many women experience an improvement in migraine symptoms, and about one-third report complete remission. The drug utilization patterns and factors predicting drug use in pregnant women with a migraine have been explored only in limited studies. The study mentioned here was conducted to elucidate the patterns of analgesic use in a sample of Norwegian pregnant women as per their migraine history, and to reveal predictors for analgesic use among these women.
Between 2008 and 2010, pregnant women giving birth at Akershus University Hospital were recruited at ultrasound examination in gestational week 17. The data collection was based on questionnaires in gestational weeks 17 and 32, and at 8 weeks postpartum, and connected to birth records. The women were grouped into 4 categories as per their migraine history: no migraine history, previous migraine history, recent migraine history (within 1 year prior to pregnancy) and migraine in pregnancy. The patterns of analgesic usage were investigated descriptively. To recognize the factors predicting analgesic use, multivariable logistic regression was used. Around 5.0% women reported having a migraine in pregnancy, 13.2% had a recent history of migraine, 11.5% had a previous history of migraine, and 68.8% reported no history of migraine out of a total of 1981 women. During pregnancy, the analgesic use decreased. Many women switched from triptans and non-steroidal anti-inflammatory drugs to paracetamol, which comprised mostly of the analgesic use. The factors concerned with analgesic use inculcated recent migraine history (OR 1.6, 95% CI 1.2–2.2), more severe headache intensity (OR 1.3, 95% CI 1.3–1.4), smoking (OR 1.9, 95% CI 1.1–3.3) and multiparity (OR 1.4, 95% CI 1.1–1.7).
It was concluded that the women with migraine stop or switch medications during pregnancy. Migraine characteristics, intensity and also the socio-demographic factors determine the analgesic use in pregnancy. For an effective management of migraine in pregnancy and safe analgesic use, the clinicians should keep these factors in mind while advising for the same.
BMC Pregnancy and Childbirth
Patterns and predictors of analgesic use in pregnancy: a longitudinal drug utilization study with special focus on women with migraine
Gerd-Marie Eskerud Harris et al.
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