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A systematic review and meta-analyses on the prevalence of pregnancy outcomes in migraine treated patients: a contribution from the IMI2 ConcePTION project

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Abstract

The present study aims to summarize the safety profile of the medications used to treat migraine during pregnancy by performing a systematic review and meta-analyses. The term “migrain*” combined with pregnancy terms were used to search Embase, PubMed, PsychInfo, Scopus, and Web of Science through 31 December 2020. Pooled prevalences of untreated and treated migraine patients were estimated using MetaXL software. Pooled odds ratios (OR) using random effects models were estimated in RevMan 5. All the identified studies assessed medications used to treat acute migraine. The pooled prevalence of adverse pregnancy outcomes in patients prescribed any migraine medication ranged from 0.4% (95% CI 0.2–0.7%) for stillbirth to 12.0% (95%CI 7.8–16.9%) for spontaneous abortions. Among untreated patients with migraine, the pooled prevalence of the assessed pregnancy outcomes ranged from 0.6% (95% CI: 0–1.7%) for stillbirth to 10.4% (95% CI: 8.9–12%) for gestational age < 37 weeks. Given the limited data, it was only possible to perform OR meta-analyses for triptans. The adjusted ORs for triptan users compared the general population were: for major malformations 1.07 (95%CI: 0.83–1.39, p = 0.60); birth weight < 2500g 1.18 (95%CI: 0.94–1.48, p = 0.16); gestational age < 37 weeks 1.49 (95% CI: 0.37–6.08, p = 0.58). In conclusion, triptans do not appear to increase the risk of pregnancy outcomes when compared to the general population. It was not possible to assess other migraine medications. Further studies are needed to investigate the safety of individual medications of acute and prophylactic migraine treatment among pregnant women.

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Acknowledgement

The ConcePTION project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 821520. This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA. The research leading to these results was conducted as part of the ConcePTION consortium. This paper only reflects the personal views of the stated authors.

Funding

Funding was provided by IMIConcePTION and Novartis.

Author information

Authors and Affiliations

  1. Novartis Pharmaceuticals Corporation, One Health Plaza, Building 339-1131, East Hanover, NJ, 07936-1080, USA

    Daniel C. Dudman & Sandra Lopez-Leon

  2. Center for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, NJ, USA

    Daniel C. Dudman & Mary E. Ritchey

  3. Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, 08854, USA

    Daniel C. Dudman

  4. PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway

    Fatima Tauqeer

  5. PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Blindern, Postbox 1068, 0316, Oslo, Norway

    Fatima Tauqeer

  6. Former Cognizant Technology Solutions, 1 Kingdom Street, London, W2 6BD, UK

    Moninder Kaur

  7. Former Eli Lilly and Company, Lilly Corporate Center, 839 Delaware St, Indianapolis, IN, 46285, USA

    Hu Li

Authors
  1. Daniel C. Dudman
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  2. Fatima Tauqeer
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  3. Moninder Kaur
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  4. Mary E. Ritchey
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  5. Hu Li
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  6. Sandra Lopez-Leon
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Corresponding author

Correspondence to Sandra Lopez-Leon.

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Conflicts of interest

DCD and SLL are employees of Novartis. MK is a former employee of Cognizant Technology Solutions on behalf of Novartis and a current employee of Barrington James Ltd on behalf of UCB. HL is a former employee of Eli Lilly and current employee of Gilead Science.

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This article does not contain any studies with human particpiants or animals performed by any of the authors.

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Dudman, D.C., Tauqeer, F., Kaur, M. et al. A systematic review and meta-analyses on the prevalence of pregnancy outcomes in migraine treated patients: a contribution from the IMI2 ConcePTION project. J Neurol 269, 742–749 (2022). https://doi.org/10.1007/s00415-021-10534-5

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  • DOI: https://doi.org/10.1007/s00415-021-10534-5

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