December 20, 2018
Women with headache or migraine during pregnancy had worse health-related quality of life.
Results from a recent retrospective observational study published in Complementary Therapies in Medicine highlighted the effect of headache or migraine on quality of life among pregnant women, their use of both conventional medicine and complementary and alternative medicine (CAM), and the influence of education level and insurance coverage on treatment-seeking.
Researchers in this study compared quality of life among a cohort of pregnant Australian women with and without migraines or headaches and their use of conventional medicine and CAM. The study participants were women (n=1835, age 31-36 years) who were currently pregnant or had recently given birth.
They completed a 28-page sub-study questionnaire as part of the Australian Longitudinal Study on Women’s Health on whether they had experienced headaches or migraines during pregnancy and subsequent treatment-seeking. They also completed the Short-Form 36 Quality of Life questionnaire on health status and quality of life.
Among the study population, 96.3% were married or in a de facto relationship, 60.1% had a university degree, 16% had a high school education only, 58.4% held private insurance that covered pregnancy, 13.6% had private insurance that did not cover pregnancy, and 63.1% lived in an urban area.
The results showed that 16% of total participants experienced headache or migraine during pregnancy, of which 66.9% sought help from a healthcare practitioner, with lesser percentages seeking care from successive health practitioners.
Participants consulted a variety of healthcare professionals including general practitioners (37.8%), obstetricians (29.6%), chiropractors (22.4%), midwives (15.3%), massage therapists (14.3%), acupuncturists (3.1%) and herbalists (1%).
Comparative analysis on Short-Form 36 Quality of Life between “pregnant women with headache or migraine who did or did not seek help” and those “who did not have headache or migraine” showed statistically significant differences in mean scores on all domains except emotional. The results showed women with no health insurance were “almost half as likely” to seek help from a practitioner compared with women with insurance that covered pregnancy. Also, women with a university degree were less likely to seek help compared with women with a high school education only.
The researchers identified study limitations as lack of specificity of the survey tool to assess health care use for headache or migraine, concerns of recall bias due to participant self-reporting, and lack of knowledge of the participants’ headache status prior to the most recent pregnancy.
The authors suggest that “all maternity care professionals should be encouraged to initiate an open conversation with pregnant women in their care about the use of CAM among other possible health-seeking to help ensure safe maternal outcomes for mothers and their babies.”
Peng W, Lauche R, Frawley J, Sibbritt D, Adams J. Utilization of complementary and alternative medicine and conventional medicine for headache or migraine during pregnancy: a cross-sectional survey of 1,835 pregnant women. Complement Ther Med. 2018;41:192-195.