Women With Chronic Migraine May Have Higher Risk for Postpartum Depression

Women with chronic migraine with or without aura may have a higher risk for postpartum depression (PPD), particularly those with preeclampsia, depression, gestational diabetes, and premenstrual dysphoric disorder compared with women without migraine, according to study results published in the Journal of Women’s Health.

Researchers conducted a retrospective observational study between January 2017 and January 2024 to evaluate the association between migraine and PPD risk among women of reproductive age, and sought to determine how comorbidities may impact this risk. Women aged 18 to 45 years who received care at a tertiary headache center or a neurology clinic were included in the study. The primary outcome was the risk for PPD among patients with either episodic or chronic migraine with or without aura compared with those without migraine. Secondary outcomes included the risk for PPD among patients with vs without comorbidities such as depression, anxiety, post-traumatic stress disorder, endometriosis, preeclampsia, gestational diabetes, premenstrual dysphoric disorder (PMDD), and older maternal age. Multivariable logistic regression was employed for statistical analysis, with adjustments for age, race, ethnicity, marital status, and comorbidities.

Among patients with episodic (n=2208) vs chronic (n=4040) migraine, the mean (SD) ages were 31.4 (7.8) vs 31.9 (8.0) years, 49.6% vs 54.4% were White, 27.2% vs 33.7% had depression, 38.5% vs 43.9% had anxiety, and 38.1% vs 41.0% had advanced maternal age, respectively. A total of 4154 patients without migraine were also included in the final analysis.

Chronic migraine with or without aura was linked to a significantly increased risk for PPD ([odds ratio], OR, 2.02; 95% CI, 1.27-3.21; P =.003). Patients with chronic migraine without aura had the highest PPD risk (OR, 2.13; 95% CI, 1.29-3.53; P =.003), followed by those with chronic migraine with aura (OR, 1.83; 95% CI, 1.03-3.27; P =.039).

A strong association with PPD was found among patients with migraine and certain comorbidities, including preeclampsia (OR, 7.91; 95% CI, 4.86-12.90; P <.001), depression (OR, 4.03; 95% CI, 2.56-6.36; P <.001), gestational diabetes (OR, 3.87; 95% CI, 2.30-6.52; P <.001), and PMDD (OR, 2.89; 95% CI, 1.30-6.47; P =.009).

In terms of management of women with chronic migraine during pregnancy and after delivery, the researchers advised, “Patients with chronic migraine should undergo screening before the 6-week postpartum appointment, and during prenatal and early postpartum visits.”

Limitations of this study include constraints on generalizability and overall statistical power of the findings owing to the demographic characteristics of the sample population.

The researchers concluded, “Our research highlights a significant association between chronic migraine and lifetime occurrence of PPD, emphasizing the importance of comprehensive healthcare management for individuals experiencing these conditions.”

This article originally appeared on Clinical Pain Advisor