Migraine and pregnancy. Gender-specific aspects and current knowledge

Background: Migraine, a frequent and debilitating neurological disease, shows gender-specific differences in prevalence and severity. Pregnancy is associated with numerous unique features in terms of migraine course, treatment options and differential diagnoses. Objectives: How does pregnancy influence the course of migraine? What are the possible treatment options during pregnancy? Which differential diagnoses should be considered? Material and methods: Narrative review with summary and discussion of relevant studies and guidelines on migraine in pregnancy. Results: During pregnancy up to three quarters of women experience improvement of their migraine; however, there may be a renewed increase in frequency after childbirth. Choosing an appropriate treatment during pregnancy requires a careful risk-benefit assessment. It is important to consider secondary causes of headache as these can occur more frequently during pregnancy and some can be life-threatening. Conclusion: Consideration of specific aspects of migraine in pregnancy is crucial to be able to develop the best possible treatment strategies for affected patients.