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Migraine aura during pregnancy1/18/2024 The remaining 3% are low-income families, and since they are covered by the government-financed Medical Aid program operated by NHIS, virtually all citizens are included in the NHIS database. The Korean NHIS is a universal health insurance service that provides comprehensive medical care to up to 97% of Koreans. Therefore, by analyzing the risk of ischemic or hemorrhagic stroke according to the presence/absence of G-HA and history of headache disorder (Hx-HA), we want to determine if women experiencing which types of headaches during pregnancy are at a higher risk for future stroke occurrences.Īll clinical data used in this study were obtained from the prospectively collected national health insurance claims database established by the Korean NHIS. G-HA may be a new headache during pregnancy or may be a continuation of a previous headache disorder. In this study, we evaluated the association between G-HA and stroke after delivery using Korean National Health Insurance Service (NHIS) data. In addition, the effect of headaches experienced during pregnancy (i.e., gestational headache ) on subsequent stroke after delivery is unknown yet. However, these studies were mainly designed as cross-sectional studies, and there was no cohort study considering the variable of time. Through several studies, migraine during pregnancy has been be associated with the occurrence of stroke during pregnancy. However, in some women, the headaches do not improve, and 3%-6% of pregnant women develop a novel headache during pregnancy. As a result of these changes, 50%-80% of migraines and 30% of other primary headache disorders are improved in the first trimester of pregnancy. When a woman becomes pregnant, a number of physiological changes, including hormonal changes, occur in the body. Therefore, identification of high-risk groups among women with primary headache disorders and appropriate management is necessary. This association was the same in patients with nonspecific primary headache disorders, excluding migraines, with a 1.5-fold to 4.0-fold increase in the risk of stroke. Women with migraines had an increased risk of ischemic stroke of 1.7 to 2.0 times compared to women without migraines, and this tendency was evident in young women under the age of 45 years. However, previous studies have shown that primary headache disorders can increase the risk of not only metabolic and cardiovascular diseases, but also cerebrovascular diseases. Most of them are primary headache disorders and have a benign clinical course when appropriate treatment is given. Headache is one of the most common symptoms that neurologists encounter in clinical practice, and it is common in young women. However, the relationship between G-HA and ischemic stroke is mitigated by a history of pre-pregnancy headache disorder. We demonstrated that G-HA was associated with subsequent stroke occurrence after delivery. When analyzed considering the interaction with history of headache disorder, G-HA showed a significant association with hemorrhagic stroke, but lost its effect on ischemic stroke. During the observational periods, the G-HA ( +) group had a significantly higher risk of any stroke, ischemic stroke (aHR = 1.50, 95% CI: 1.12–2.01), hemorrhagic stroke (aHR = 1.63, 95% CI: 1.23–2.15), and intracerebral hemorrhage (aHR = 1.63, 95% CI: 1.19–2.23) than the G-HA (-) group. All diseases were identified based on data registered in the database using the International Classification of Disease-10 th Revision-Clinical Modification codes. Primary outcome was any stroke that occurred during the observational periods from delivery to December 31, 2020. G-HA was defined as a headache diagnosed during pregnancy. Methodsīased on the Korean National Health Insurance Service database, we included women hospitalized for delivery between 20. In this study, we evaluated the association between G-HA and stroke after delivery in women. However, despite this, some women develop headaches during pregnancy (G-HA), and the effect of this headache on subsequent stroke is unknown. Primary headache disorder is a known risk factor for stroke in women and usually improves during the first trimester of pregnancy.
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