Migraine, associated treatments and risk of miscarriage: A matched cohort study and nested case-control study using the CPRD pregnancy register
Abstract
Objective To estimate the risk of miscarriage amongst pregnant women with migraine compared to pregnant women without migraine. To compare the odds of miscarriage in women taking medication for migraine to women with migraine who did not take medication and to explore this association with different types of medications. Design Matched cohort study and nested case-control. Setting Clinical Practice Research Datalink (CPRD) GOLD pregnancy register. All pregnancies meeting data quality requirements between 2000 and 2019 were eligible for inclusion. Participants Cohort study: 193,208 pregnancies of women with migraine were matched one-to-one to women without migraine. Nested case-control: 20,778 pregnancies of women with migraine that ended in miscarriage were matched to 40,122 pregnancies of women with migraine that did not end in miscarriage. Main outcome measures Cohort study: miscarriage recorded in primary care. Nested case-control: odds of miscarriage amongst migraineurs using migraine medication. Results Miscarriage occurred in 10% (n = 19,233) of women without migraine compared to 10.8% (n = 20,778) of women with migraine. Having migraine was associated with an 8% higher relative risk of miscarriage (risk ratio (RR) 1.08, 95% confidence interval (CI) 1.06–1.10, p < 0.001) and remained significant after adjustment for demographic factors, body mass index (BMI), smoking and comorbidities (aRR 1.06 95% CI [1.04–1.08][p = 0.001]). Of the pregnancies ending in miscarriage,…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 193,208 participants or records.
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