Women with migraine headache are more likely to develop preeclampsia and women with either migraine or preeclampsia are at increased risk of stroke.

Kathryn L. Adeney, MPH; Michelle A.Williams, ScD

Objective
To summarize and evaluate available empirical research on the relationship between migraines and gestational hypertension or preeclampsia and to provide direction for future research in this area.

Background
Migraines affect a substantial proportion of reproductive-agedwomen and have been associated with cardiovascular risk factors and ischemic disease in this population. Preeclampsia is a vascular disorder of pregnancy, also linked to adverse cardiovascular outcomes.

Methods
Publications were identified by a MEDLINE search using keywords "migraine," "preeclampsia," and "gestational hypertension," and by examination of the reference lists of identified articles.

Results
The literature review yielded 10 studies addressing the association between migraines and preeclampsia or gestational hypertension. Of the 10 studies, 8 reported a positive association between the syndromes.

Conclusions
Available evidence suggests that migraines and preeclampsia may reflect an underlying predisposition toward ischemic injury. More rigorous epidemiologic research is warranted, after consideration of several important methodologic issues.

SUMMARY
Given the high prevalence of migraines in reproductive-age women, that 8 of 10 studies have indicated an association between migraines and pregnancy-induced hypertension (or preeclampsia), and that available evidence suggest that women with either condition are at increased risk of stroke, more rigorous epidemiologic and laboratory studies are needed to clarify the relationship. A true association between migraines and preeclampsia may yield further clues to the mysterious etiologies of both disorders.

If certain women are predisposed to endothelial Headache dysfunction and ischemia (placental or cerebral), they may be at elevated risk for stroke and severe cerebral damage.

Early diagnosis and treatment of migraine may help prevent adverse pregnancy outcomes and future occurrence of serious vascular disorders.

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