Headache Medicine, v.2, n.2, p.73, Apr./May/Jun. 2011 73

Associated factors to the course of migraine during pregnancy

and the role of exclusive breast-feeding in the recurrence of

migraine in the postpartum period (Abstract)

Fatores associados ao curso da enxaqueca durante a gestação e o papel do

aleitamento materno exclusivo na sua recorrência no pós-parto (Resumo)

The course of migraine during the women's reproductive

life is influenced by cyclical fluctuations in sex hormones, with

attacks that occur predominantly during the menstrual period.

Changes in the frequency of migraine attacks can also occur

during pregnancy, lactation, oral contraceptive use and

menopause.

The objective of the present study was to describe the

course of migraine with and without aura during pregnancy,

its classification and factors that could influence its course,

also to observe migraine recurrence at the first postpartum

week and follow it up prospectively at the fourth postpartum

week, among migraine sufferers before pregnancy and

compare migraine recurrence between women that were

exclusively breastfeeding with those that used other types of

infant feeding.

It is a follow up study with two components, retrospective

and prospective, undertaken at the Instituto de Medicina

Integral Professor Fernando Figueira (IMIP), Brazil, during a

period of six months. Out of 686 consecutively assisted women,

at the first postnatal week, 266 were identified as migraine

sufferers before pregnancy, then, the first part of a formulary

that responded questions related to pregnancy and the

immediate postpartum period was applied. Among those, one

in five women that were exclusively breastfeeding (53 women)

and all the ones consecutively using others forms of infant

feeding (40 women) were part of a subgroup, with a total of

93 women, for the prospective study. A new investigation was

performed at the fourth postpartum week to investigate migraine

recurrence. There was migraine remission in 35.4%, 76.8%

and 79.3% among migraine without aura sufferers and 20.7%,

58.6% and 65.5% among those with migraine with aura,

respectively in the first, second and third trimesters. Statistically

significant difference was found when the first trimester was

Waldmiro Antonio Diégues Serva

Universidade Federal de Pernambuco. Pós-graduação de Neuropsiquiatria e Ciências do Comportamento

(área de concentração: Neurologia). Ph.D. Thesis. Recife, 2011. Orientador: Marcelo Moraes Valença

Serva W. A. D. Associated factors to the course of migraine during pregnancy and the role of exclusive breast-

feeding in the recurrence of migraine in the postpartum period (Abstract). Headache Medicine. 2011;2(2):73

Correspondence

DrDr

. W. W

. W

aldmiro Antonio Diégues Servaaldmiro Antonio Diégues Serva

aldmiro Antonio Diégues Serva

wserva@hotmail.com

compared with the second and third trimesters. However, there

was no difference between the second and third trimesters.

The factors associated with the presence of migraine during

pregnancy were menstrually related migraine without aura prior

to pregnancy in the first trimester, multiparity in the first and

second trimesters and illness during pregnancy in the first and

third trimesters. There was migraine recurrence in 35.5% and

54.8%, respectively, on the first and fourth postpartum week.

After multivariable analysis, exclusive breastfeeding, no

breastfeeding problems and low income (less than half per

capita minimum national wage) were associated with a lower

chance of migraine recurrence at the first postpartum week.

At the fourth postnatal week, exclusive breastfeeding continued

to be a protective factor for migraine recurrence among

antenatal migraine sufferers.

The study contributed to elucidate the course of migraine

during pregnancy and to show that the less frequent postpartum

migraine recurrence in the first and fourth postpartum week,

among antenatal migraine sufferers, seems to be another

advantage of exclusive breastfeeding.

THESESTHESES

THESES