ArticleFrontiers in pharmacology2024
Anti-migraine medications safety during pregnancy in the US.
Article in Frontiers in pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sex-specific management of migraine a systematic review and consensus statement from the European Headache Federation (EHF).The journal of headache and pain · 2026Pooled it
- Review
- Safety and Effectiveness of Pain Medications for Migraine Management During Pregnancy and Lactation.Paediatric drugs · 2026Review
- Pharmacokinetics of Atogepant in Healthy Lactating Female Participants: Results from a Phase 1 Lactation Study.Neurology and therapy · 2025Article
- Headaches and family planning: insights from a Japanese school-based survey.The journal of headache and pain · 2025Article
- Do headaches impact pregnancy planning behaviors? A cross-sectional school-based study in Japan.The journal of headache and pain · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Specific antimigraine medications (dihydroergotamine (DHE), triptans) have been associated with adverse pregnancy outcomes in individual studies but lack of consensus remains. Objectives: Quantify the risk of prematurity, low birth weight (LBW), major congenital malformations (MCM), and spontaneous abortions (SA) associated with gestational use of DHE or triptans in a privately insured cohort of pregnant women in the US. Methods: We conducted a cohort study within the US Merative MarketScan Research Database (2011-2021), composed of a nationally representative sample of patients with employer-provided health insurance. Four independent analyses were conducted to assess the risk of 1) prematurity (<37 weeks of gestation), 2) LBW (birth weight <2,500 g), 3) MCM, and 4) clinically detected SA. Exposure was defined dichotomously as use of DHE or triptan during pregnancy. Generalized estimation equations (GEE) were built to quantify the associations taking into account potential confounders including maternal migraine. Results: Overall, 767,994 pregnant women met eligibility criteria and were included in the analyses on prematurity, LBW, and MCM; 11,121 cases of SA were identified and analyzed. One hundred and eighty-nine (189 (0.02%)) were exposed to DHE (all in the first trimester), and 4,309 (0.56%) to triptans. Adjusting for potential confounders including maternal migraine, DHE was not associated with a statistically significant risk of prematurity (adjusted RR (aRR) 1.17, 95%CI 0.14, 9.74), LBW (aRR 7.76, 95%CI 0.99, 60.83), MCM (aRR 2.27, 95%CI 0.97, 5.29), or SA (aOR 3.19, 95%CI 0.98, 10.38); DHE was associated with an increased risk of septal defects. All estimates showed increased risk but were unstable. Similarly, triptan use was not associated with any of the studied outcomes. Discussions and Conclusions: After considering maternal migraine and other potential confounders, DHE (first trimester) and triptan exposure during pregnancy were not statistically significantly associated with an increased risk for prematurity, LBW, MCM, or SA. Findings on septal defects could be due to chance, and need replication.
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