Warning Signs: Headaches During Pregnancy

Headaches during pregnancy can signal serious conditions like preeclampsia

For pregnant women, a headache is often no big deal. Sometimes, however, it can be a warning sign.

Researchers from Montefiore Health System and Albert Einstein College of Medicine have developed the first clinical guidelines for headaches in pregnant women. This research may help doctors determine when a headache is something to worry about.

"Headaches during pregnancy are quite common, but it is not always easy to distinguish between a recurring, preexisting migraine condition and a headache caused by a pregnancy complication," said lead author Matthew S. Robbins, MD, chief of neurology at Jack D. Weiler Hospital, in a press release. "Our study suggests that physicians should pay close attention when a pregnant woman presents with a severe headache, especially if she has elevated blood pressure or lack of past headache history. Those patients should be referred immediately for neuroimaging and monitoring for preeclampsia."

For their study, Dr. Robbins and colleagues studied the records of every pregnant woman with a headache who had been referred for a neurology consult at Weiler Hospital over a five-year period. The study population of 140 women was primarily Hispanic and black. Patients were 29 years old on average.

Most of the women had headaches like migraines. However, 49 patients had headaches for some other reason. Of those, 51 percent had pregnancy-related high blood pressure.

Preeclampsia is a complication of pregnancy that usually occurs during the second or third trimester. Once known as toxemia, it can cause high blood pressure, headaches and blurry vision. Preeclampsia can pose serious health risks to both mother and baby.

Dr. Robins and colleagues found that women with a headache plus high blood pressure were 17 times more likely than those with normal blood pressure to have a headache because of preeclampsia. The researchers also found that a woman who did not have a history of headaches was five times more likely to have a headache because of a problem like preeclampsia.

Other potential warning signs were seizures, headaches plus fever, headaches without sensitivity to noise and headaches without psychiatric problems.

This study was published in the August issue of the journal Neurology.

This research did not receive outside funding.

Study author Dr. Richard Lipton served on the editorial board of Neurology, held stock options in eNeura Therapeutics, and consulted for or received fees from Boehringer-Ingelheim, Boston Scientific, Bristol-Myers Squibb, CogniMed, CoLucid, Eli Lilly, Endo, GlaxoSmithKline, Merck, Novartis and Pfizer.