All Title Author
Keywords Abstract

Publish in OALib Journal
ISSN: 2333-9721
APC: Only $99


Relative Articles


Risk Factors Associated with Cephalalgia during Pregnancy and Postpartum in a Sample of Greek Women

DOI: 10.4236/ojmp.2023.122005, PP. 82-93

Keywords: Cephalalgia, Pregnancy, Postpartum, EPDS, WAST

Full-Text   Cite this paper   Add to My Lib


Background: The two most common types of cephalalgia in women are migraine and tension-type cephalalgia. Cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Objectives: To investigate the prevalence and the characteristics of maternal cephalalgia during pregnancy and early postpartum and identify associated risk factors. Study Design: This study was conducted between May 2012 and August 2012. The study population comprised 170 mothers. The interviews were conducted in a postnatal ward during the first postpartum week and information on the characteristics of maternal cephalalgia before and during pregnancy was collected. Data regarding previous history of cephalalgia, pregnancy and postpartum health history, as well as the mode of delivery were also recorded. Mothers were given a cephalalgia diary in order to record medication use, as well as cephalalgia attack frequency, severity (5-level scale) and duration. The following surveys were administered: Edinburgh Postnatal Depression Scale (EPDS), Mediterranean Diet Score (Medi Score), International Physical Activity Questionnaire (IPAQ) and Women Abuse Screening Tool (WAST) within the first week postpartum. Statistical analyses were performed using SPSS 19. The level of statistical significance was set at p < 0.05. Results: Maternal self-reported cephalalgia in pregnancy and early postpartum was significantly associated with scores in EPDS (depressive symptoms) (p = 0.005), hypertension (p < 0.004), thyroid pathology (p < 0.003), IVF (p < 0.006) and psychological abuse (p < 0.001). Mothers with a previous history of cephalalgia (51.8%) did not experience any worsening or even experience improvement of symptoms during pregnancy or early postpartum. A significant proportion of pregnant women who did experience cephalalgia used paracetamol/acetaminophen (56.5%), aspirin (32.3%), or triptans (6.5%), while 36.8% did not use any medication. Conclusion: Pregnancy and early postpartum is a graceful period in women with cephalalgia. However, cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Further studies should elucidate the safety and recommended use of cephalalgia medication during pregnancy and breastfeeding.


[1]  Carson, A.J., Ringbauer, B., Mac Kenzie, L., et al. (2000) Neurological Disease, Emotional Disorder, and Disability: They Are Related: A Study of 300 Consecutive New Referrals to the Neurology Outpatient Department. Journal of Neurology, Neurosurgery and Psychiatry, 68, 202-206.
[2]  Ryan, R.E. and Pearlman, S.H. (2004) Common Headache Misdiagnoses. Primary Care, 31, 395-405.
[3]  Delaruelle, Z., Ivanova, T.A., Khan, S., et al. (2018) Male and Female Sex Hormones in Primary Headaches. The Journal of Headache and Pain, 19, Article No. 117.
[4]  Silberstein, S.D. (2001) Headache and Female Hormones: What You Need to Know. Current Opinion in Neurology, 14, 323-333.
[5]  Silberstein, S.D. (2000) Sex Hormones and Headache. Revue Neurologique (Paris), 156, 4S30-4S41.
[6]  Faubion, S.S., Batur, P. and Calhoun, A.H. (2018) Migraine throughout the Female Reproductive Life Cycle. Mayo Clinic Proceedings, 93, 639-645.
[7]  Olesen, J., Tfelt-Hansen, P., Ramasan, N., Goadsby, P.J. and Welvh, K.M.A. (2005) The Headaches. Lippincott, Williams, Wilkins, Philadelphia.
[8]  Negro, A., Delaruelle, Z., Ivanova, T.A., Khan, S., Ornello, R., Raffaelli, B., Terrin, A., Reuter, U. and Mitsikostas, D.D. (2017) Headache and Pregnancy: A Systematic Review. The Journal of Headache and Pain, 18, Article No. 106.
[9]  Dzolijic, E., Sipetic, S., Vlajinac, H., et al. (2002) Prevalence of Menstrually Related Migraine and Nonmigraine Primary Headache in Female Students of Belgrade University. Headache, 42, 185-193.
[10]  Kvisvik, E.V., Stovner, L.J., Helde, G., Bovim, G. and Linde, M. (2011) Headache and Migraine during Pregnancy and Puerperium: The MIGRA-Study. The Journal of Headache and Pain, 12, 443-451.
[11]  Μacgregor, E.A. (2014) Migraine in Pregnancy and Lactation. Neurological Sciences, 35, 61-64.
[12]  Pearce, C.F. and Hansen, W.F. (2012) Headache and Neurological Disease in Pregnancy. Clinical Obstetrics and Gynecology, 55, 810-828.
[13]  Menon, R. and Bushnell, C.D. (2008) Headache and Pregnancy. Neurologist, 14, 108-119.
[14]  Aukes, A.M., Yurtsever, F.N., Boutin, A., Visser, M.C. and De Groot, C.J.M. (2019) Associations between Migraine and Adverse Pregnancy Outcomes: Systematic Review and Meta-Analysis. Obstetrical & Gynecological Survey, 74, 738-748.
[15]  Kajaa, N., Szeoligeti, S.K., Xue, F., Sorensen, H.T., Ehrenstein, V., Eisele, O. and Adelborg, K. (2019) Pregnancy, Birth, Neonatal and Postnatal Neurological Outcomes after Pregnancy with Migraine. Headache, 59, 869-879.
[16]  Gerber, M.R., Fried, L.E., Pineles, S.L., Shipherd, J.C. and Bernstein, C.A. (2012) Posttraumatic Stress Disorder and Intimate Partner Violence in a Women’s Headache Center. Women Health, 52, 454-471.
[17]  Gelaye, B., Do, N., Avila, S., CarlosVelez, J., Zhong, Q.Y., Sanchez, S.E., Peterlin, B.L. and Williams, M.A. (2016) Childhood Abuse, Intimate Partner Violence and Risk of Migraine among Pregnant Women: An Epidemiologic Study. Headache, 56, 976-986.
[18]  Cripe, S.M., Sanchez, S., Lam, N., Sanchez, E., Ojeda, N., Tacuri, S, Segura, C. and Williams, M.A. (2010) Depressive Symptoms and Migraine Comorbidity among Pregnant Peruvian Women. The Journal of Affective Disorders, 122, 149-153.
[19]  Cox, J., Holden, M. and Sagovsky, R. (1987) Detection of Postnatal Depression: Development of 10-Item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782-786.
[20]  Beck, A.T., Ward, C.H., Mendelson, M., Mock, J. and Erbaugh, J. (1961) An Inventory for Measuring Depression. Archives of General Psychiatry, 4, 561-571.
[21]  Vivilaki, V.G., Dafermos, V., Kogevinas, M., Bitsios, P. and Lionis, C. (2009) The Edinburgh Postnatal Depression Scale (EPDS): Translation and Validation for a Greek Sample. BMC Public Health, 9, Article No. 329.
[22]  Brown, J.B., Lent, B., Brett, P.J., Sas, G. and Pederson, L.L. (1996) Development of the Woman Abuse Screening Tool for Use in Family Practice. Family Medicine, 28, 422-428.
[23]  Brown, J.B., Lent, B., Schmidt, G. and Sas, G. (2000) Application of the Woman Abuse Screening Tool (WAST) and WAST-Short in the Family Practice Setting. The Journal of Family Practice, 49, 896-903.
[24]  Vivilaki, V.G., Dafermos, V., Daglas, M., Antoniou, E., Tsopelas, N.D., Theodorakis, P.N., Brown, J.B. and Lionis, C. (2010) Identifying Intimate Partner Violence (IPV) during the Postpartum Period in a Greek Sample. Archives of Women’s Mental Health, 13, 467-476.
[25]  Panagiotakos, D.B., Pitsavos, C. and Stefanadis, C. (2006) Dietary Patterns: A Mediterranean Diet Score and Its Relation to Clinical and Biological Markers of Cardiovascular Disease Risk. Nutrition, Metabolism and Cardiovascular Diseases, 16, 559-568.
[26]  Craig, C.L., Marshall, A.L., Sjostrom, M., Bauman, A.E., Booth, M.L., Ainsworth, B.E., et al. (2003) International Physical Activity Questionnaire: 12-Country Reliability and Validity. Medicine and Science in Sports and Exercise, 35, 1381-1395.
[27]  Papathanasiou, G., Georgoudis, G., Papandreou, M., Spyropoulos, P., Georgakopoulos, D., Kalfakakou, V. and Evangellou, A. (2009) Reliability Measures of the Short International Physical Activity Questionnaire (IPAQ) in Greek Young Adults. Hellenic Journal of Cardiology, 50, 283-294.
[28]  Papathanasiou, G., Georgoudis, G., Georgakopoulos, D., Katsouras, C., Kalfakakou, V. and Evangellou, A. (2010) Criterion-Related Validity of IPAQ-Short against Exercise Capacity in Young Adults. European Journal of Cardiovascular Prevention and Rehabilitation, 17, 380-386.
[29]  Chen, S.F., Chen, Y.H. and Lin, H.C. (2010) Increased Risk of Adverse Pregnancy Outcomes for Women with Migraines: A Nationwide Population-Based Study. Cephalalgia, 30, 433-438.
[30]  Sanchez, S.E., Williams, M.A., Pacora, P.N., et al. (2010) Risk of Placental Abruption in Relation to Migraines and Headaches. BMC Women’s Health, 10, Article No. 30.
[31]  Marcoux, S., Berube, S., Brisson, J. and Fabia, J. (1992) History of Migraine and Risk of Pregnancy Induced Hypertension. Epidemiology, 3, 53-56.
[32]  Girardi, P., Pompili, M., Innamorati, M., Serafini, G., Berrettoni, C., Angeletti, G., Koukopoulos, A., Tatarelli, R., Lester, D., Roselli, D. and Primiero, F.M. (2011) Temperament, Post-Partum Depression, Hopelessness, and Suicide Risk among Women Soon after Delivering. Women Health, 22, 511-524.
[33]  Grossman, T.B., Robbins, M.S., Govindappagari, S. and Dayal, A.K. (2017) Delivery Outcomes of Patients with Acute Migraine in Pregnancy: A Retrospective Study. Headache, 57, 605-611.
[34]  Marchenko, A., Etwel, F., Olutunfese, O., Nickel, C., Koren, G. and Nulman, I. (2015) Pregnancy Outcome Following Prenatal Exposure to Triptan Medications: A Meta-Analysis. Headache, 55, 490-501.
[35]  Anderson, J.C. and Gerbing, D.W. (1984) The Effect of Sampling Error on Convergence, Improper Solutions, and Goodness of Fit Indices for Maximum Likelihood Confirmatory Factor Analysis. Psychometrika, 49, 155-173.


comments powered by Disqus

Contact Us


WhatsApp +8615387084133

WeChat 1538708413