Medicines for headache before and during pregnancy: a retrospective cohort study (ATENA study)
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ORIGINAL ARTICLE
Medicines for headache before and during pregnancy: a retrospective cohort study (ATENA study) Chiara Lupi 1 & Andrea Negro 2
1
3
& Elisabetta Gambassi & Tommaso Susini & Pierangelo Geppetti
1,4
& Silvia Benemei
1
Received: 7 May 2020 / Accepted: 29 August 2020 # The Author(s) 2020
Abstract Objective To investigate headache treatment before and during pregnancy. Background Most headaches in pregnancy are primary disorders. Headaches are likely to ameliorate during pregnancy, although they may also begin or worsen. Most headache medications should be avoided during pregnancy because of potential fetal risks. However, only scarce evidence on headache drug consumption during pregnancy is available. Design ATENA was a retrospective, self-administered questionnaire-based, cohort study on women in either pregnancy or who have just delivered and reporting headache before and/or during pregnancy. Results Out of 271 women in either pregnancy or who have just delivered, 100 (37%) reported headache before and/or during pregnancy and constituted our study sample. Before pregnancy, the attitude toward the use of symptomatic drugs was characterized by both a strong focus on their safety and the willingness to avoid possible dependence from them. Compared to the year before, pregnancy led to changes in behavior and therapeutic habits as shown by a higher proportion of patients looking for information about drugs (44/100 [44%] vs. 36/100 [36%]) and a lower proportion of those treating headache attacks (88/100 [88%] vs. 52/100 [52%]) and by a lower use of nonsteroidal anti-inflammatory drugs (68/100 [68%] vs. 5/100 [5%]) and a much higher use of paracetamol (33/100 [33%] vs. 95/100 [95%]). Conclusions Pregnancy changes how women self-treat their headache, and leads to search for information regarding drug safety, mostly due to the perception of fetal risk of drugs. Healthcare providers have to be ready to face particular needs of pregnant women with headache. Keywords Drugs . Headache . Migraine . Cohort study . Pregnancy . Fetal risk
Chiara Lupi, Andrea Negro, and Elisabetta Gambassi equally contributed to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10072-020-04702-0) contains supplementary material, which is available to authorized users. * Andrea Negro [email protected] 1
Headache Centre, Careggi University Hospital, Florence, Italy
2
Regional Referral Headache Centre, Sant’Andrea Hospital, Department of Clinical and Molecular Medicine, Sapienza University, Via di Grottarossa 1035-1039, 00189 Rome, Italy
3
Maternal and Child Department, Careggi University Hospital, Department of Health Sciences, University of Florence, Florence, Italy
4
Department of Health Sciences, University of Florence, Florence, Italy
Abbreviations NRS Numeric rating scale NSAIDs Nonsteroidal anti-inflammatory drugs
Background Headache is a common symptom in women, affecting almost 20% of female general population as a primary disorder [1]. The occurrenc
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