As you can imagine, carrying another human life inside of you is hard work. With all of those hormones running around, increased blood volume, and circulation, women should expect to suffer a headache every once in a while, but they should also know when that headache requires a doctor’s attention. A recent study conducted at Montefiore Health System and Albert Einstein College of Medicine of Yeshiva University has found that secondary headaches during pregnancy could be a sign of much more serious issues, including preeclampsia.

"Headaches during pregnancy are quite common, but it is not always easy to distinguish between a recurring, preexisting migraine condition and a headache caused by a pregnancy complication," Dr. Matthew S. Robbins, director of inpatient services at Montefiore Headache Center, said in a statement.

Robbins and his colleagues gathered medical records from 140 pregnant women around the age of 29 who were referred to Weiler Hospital for neurological consultation. A total of 91 women had primary headaches and 49 women with secondary headaches. Headaches are generally split into two categories with primary headaches being far more common than secondary. While primary headaches include migraines, tension-type, and cluster, secondary headaches are often the result of serious diseases.

Ninety percent of primary headaches from the study turned out to be migraines, while 51 percent of women with secondary headaches were diagnosed with high blood pressure and 38 percent with preeclampsia. The research team also discovered a number of red flags that pointed to a headache being a much more serious issue. For example, women with a secondary headache plus high blood pressure faced a 17-fold increased risk for an underlying condition, especially preeclampsia. No previous history of headaches also increased that likelihood five-fold.

"Our study suggests that physicians should pay close attention when a pregnant woman presents with a severe headache, especially if she has elevated blood pressure or lack of past headache history,” said Robbins who is also chief of neurology at Jack D. Weiler Hospital of Montefiore. “Those patients should be referred immediately for neuroimaging and monitoring for preeclampsia."

According to the Preeclampsia Foundation, preeclampsia is a condition that can occur during a woman’s pregnancy or postpartum period and can affect both mother and child. It is often related to an abnormal interaction of blood vessels that supply the placenta. Between five and eight percent of all pregnancies are affected by preeclampsia, which is characterized by high blood pressure and protein in the urine. Other important symptoms include swelling, weight gain, headaches, and changes in vision.

Source: Farmakidis C, Dayal A, Lipton R, Robbins M. Acute headache diagnosis in pregnant women: a hospital-based study. Neurology. 2015.