Am J Perinatol 2021; 38(S 01): e102-e108
DOI: 10.1055/s-0040-1705180
Original Article

Randomized Controlled Trials of Headache Treatments in Pregnancy: A Systematic Review

Elisa T. Bushman
1  Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
2  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Gabriella Cozzi
1  Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
2  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Rachel G. Sinkey
1  Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama
2  Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Catherine H. Smith
3  Lister Hill Library of the Health Sciences, University of Alabama at Birmingham, Birmingham, Alabama
,
Michael W. Varner
4  Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah
,
Kathleen Digre
5  Departments of Neurology and Ophthalmology, University of Utah Health Sciences Center, Salt Lake City, Utah
› Author Affiliations

Abstract

Objective Headaches affect 88% of reproductive-aged women. Yet data are limited addressing treatment of headache in pregnancy. While many women experience improvement in pregnancy, primary and secondary headaches can develop. Consequently, pregnancy is a time when headache diagnosis can influence maternal and fetal interventions. This study was aimed to summarize existing randomized control trials (RCTs) addressing headache treatment in pregnancy.

Study Design We searched PubMed, CINAHL, EMBASE, ClinicalTrials.gov, Cochrane Library, CINAHL, and SCOPUS from January 1, 1970 through June 31, 2019. Studies were eligible if they were English-language RCTs addressing treatment of headache in pregnancy. Conference abstracts and studies investigating postpartum headache were excluded. Three authors reviewed English-language RCTs addressing treatment of antepartum headache. To be included, all authors agreed each article to meet the following criteria: predefined control group, participants underwent randomization, and treatment of headache occurred in the antepartum period. If inclusion criteria were met no exclusions were made. Our systematic review registration number was CRD42019135874.

Results A total of 193 studies were reviewed. Of the three that met inclusion criteria all were small, with follow-up designed to measure pain reduction and showed statistical significance.

Conclusion Our systematic review of RCTs evaluating treatment of headache in pregnancy revealed only three studies. This paucity of data limits treatment, puts women at risk for worsening headache disorders, and delays diagnosis placing both the mother and fetus at risk for complications.



Publication History

Received: 12 December 2019

Accepted: 29 January 2020

Publication Date:
02 March 2020 (online)

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