Primary and Secondary Headache During Pregnancy

Among pregnant women receiving inpatient neurologic consultation, more than one-third have secondary headache, according to a study of 140 pregnant women presenting with acute headache. Researchers found:

• The women had a mean age of 29 years and 56.4% presented in the third trimester.

• Diagnoses were 65.0% primary and 35% secondary disorders.

• Most common primary headache disorder was migraine (91.2%) and secondary headache disorders were hypertensive disorders (51.0%).

• Groups were similar in demographics, gestational ages, and most headache features.

• In univariate analysis, secondary headaches were associated with: lack of headache history, seizures, elevated blood pressure, fever, and an abnormal neurological exam.

• In multivariate logistic regression, elevated blood pressure and a lack of headache history had an increased association with secondary headache, while psychiatric comorbidity and phonophobia had a reduced association with secondary headache.

Citation: Robbins MS, Farmakidis C, Dayal AK, Lipton RB. Acute headache diagnosis in pregnant women: A hospital-based study. [Published online ahead of print August 19, 2015]. Neurology. doi:  http:/​/​dx.​doi.​org/​10.​1212/​WNL.​0000000000001954.