Migraine is a common chronic-episodic disorder of idiopathic origin characterized by severe debilitating headaches and autonomic nervous system dysfunction, often accompanied by neurological symptoms, and distinguished from tension-type headaches by the moderate to severe intensity, unilateral location, the presence of nausea, and sensitivity to activity and/or stimuli. The lifetime prevalence of migraine in women has been reported between 14-25 per cent with increasing prevalence during the childbearing years. Preeclampsia, a vascular disorder of pregnancy, characterized by hypertension and proteinuria, complicates up to 8 per cent of all pregnancies, and it is a leading cause of maternal morbidity worldwide. A handful of studies have documented an elevated risk of pregnancy-induced hypertension or preeclampsia among migraineurs. Methodological limitations hinder causal inference from available studies. We propose a prospective cohort study of 2,000 pregnant nulliparous women to further examine the relationship between migraines and preeclampsia. The overall aim of the proposed research is to evaluate whether, and to what extent, maternal pre-gestational history of migraines and migraines symptom during early pregnancy are associated with preeclampsia risk; and (2) to evaluate mechanistic hypotheses concerning the role of platelet aggregation and activation in preeclampsia. We will collect maternal blood samples during the first trimester of pregnancy. During in-person interviews, women will be asked to provide information regarding physician diagnosed migraine and migraine symptoms. Women who screen positive for migraine and/or who report a prior medical diagnosis of migraine will have a follow-up interview with a board certified neurologist to confirm migraine status. Labor and delivery medical records will be reviewed to collect information about the study pregnancy. Indices of maternal platelet aggregation and activation will be assessed using flow cytometric methods. Statistical analyses will focus on determining: (1) the extent to which a history of pre-gestational migraines is associated with subsequent risk of preeclampsia; (2) whether migraine symptoms in early pregnancy and medications used to treat migraines are independently associated with preeclampsia risk; and (3) whether biological markers of platelet aggregation and activation in early pregnancy, are associated with maternal migraine status and subsequent risk of preeclampsia. Increased knowledge concerning the epidemiology and pathophysiology of preeclampsia and migraines, particularly as they relate to pro- inflammatory platelet adhesion to leukocytes during pregnancy will aid in understanding underlying mechanisms and lead to the identification of possible prevention and therapeutic strategies.

Public Health Relevance

Migraine, a common chronic-episodic disorder characterized by severe debilitating headaches and autonomic nervous system dysfunction, has a lifetime prevalence of 14- 25 per cent in women. Preeclampsia, a vascular disorder of pregnancy, complicates up to 8 per cent of pregnancies, and is a leading cause of maternal morbidity worldwide. Some studies have documented an elevated risk of preeclampsia among women with migraines. Our proposed research will evaluate whether, and to what extent, maternal pre-gestational history of migraines and migraine symptoms during early pregnancy are associated with preeclampsia risk; and evaluate possible physiological ? ? mechanisms of this association concerning the role of platelet aggregation and activation in preeclampsia. Increased knowledge concerning the epidemiology and pathophysiology of preeclampsia and migraines, particularly as they relate to pro-inflammatory platelets adhesion to leukocytes during pregnancy will aid in understanding underlying mechanisms and lead to the identification of possible prevention and therapeutic strategies. ? ? ? ?

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD055566-01A2
Application #
7526229
Study Section
Infectious Diseases, Reproductive Health, Asthma and Pulmonary Conditions Study Section (IRAP)
Program Officer
Reddy, Uma M
Project Start
2008-08-15
Project End
2013-07-31
Budget Start
2008-08-15
Budget End
2009-07-31
Support Year
1
Fiscal Year
2008
Total Cost
$602,448
Indirect Cost
Name
Swedish Medical Center, First Hill
Department
Type
DUNS #
079264420
City
Seattle
State
WA
Country
United States
Zip Code
98122
Qiu, Chunfang; Lawrence, Wayne; Gelaye, Bizu et al. (2017) Risk of glucose intolerance and gestational diabetes mellitus in relation to maternal habitual snoring during early pregnancy. PLoS One 12:e0184966
Mohanty, April F; Siscovick, David S; Williams, Michelle A et al. (2016) Periconceptional seafood intake and pregnancy complications. Public Health Nutr 19:1795-803
Qiu, Chunfang; Gelaye, Bizu; Zhong, Qiu-Yue et al. (2016) Construct validity and factor structure of the Pittsburgh Sleep Quality Index among pregnant women in a Pacific-Northwest cohort. Sleep Breath 20:293-301
Mohanty, April F; Thompson, Mary Lou; Burbacher, Thomas M et al. (2015) Periconceptional Seafood Intake and Fetal Growth. Paediatr Perinat Epidemiol 29:376-87
Dishi, Michal; Hevner, Karin; Qiu, Chunfang et al. (2015) Early Pregnancy Maternal Hepatocyte Growth Factor and Risk of Gestational Diabetes. Br J Med Med Res 9:
Mohanty, April F; Farin, Fred M; Bammler, Theo K et al. (2015) Infant sex-specific placental cadmium and DNA methylation associations. Environ Res 138:74-81
Qiu, Chunfang; Frederick, Ihunnaya O; Sorensen, Tanya et al. (2015) Sleep disturbances among pregnant women with history of migraines: A cross-sectional study. Cephalalgia 35:1092-102
Gelaye, Bizu; Larrabure-Torrealva, Gloria T; Qiu, Chunfang et al. (2015) Fasting lipid and lipoproteins concentrations in pregnant women with a history of migraine. Headache 55:646-57
van Uitert, Miranda; Moerland, Perry D; Enquobahrie, Daniel A et al. (2015) Meta-Analysis of Placental Transcriptome Data Identifies a Novel Molecular Pathway Related to Preeclampsia. PLoS One 10:e0132468
Cripe, Swee May; Espinoza, Damarys; Rondon, Marta B et al. (2015) Preferences for intervention among Peruvian women in intimate partner violence relationships. Hisp Health Care Int 13:27-37

Showing the most recent 10 out of 36 publications