Is Pregnancy Causing My Headaches?

Updated on Mar 10, 2023 | Pregnancy, Women's Health, Your Health

While pregnancy brings joy and excitement for many people, it can also cause quite a few headaches. Headaches are common during pregnancy, especially early on. However, there are ways to manage the pain. Most often, headaches are not serious and do not cause harm. But it is important for you and your physician to monitor your headaches, as headaches can be associated with pre-eclampsia, a condition that can become serious and lead to complications. In this Q&A, Mount Sinai obstetricians Bruno Caridi, MD, and Jian Jenny Tang, MD, explain the different types of headaches you may experience, how to ease and prevent headaches, and how to know if you should be concerned.

Bruno Caridi, MD

How common are headaches during pregnancy?
Headaches are a very common medical condition, especially among those who are pregnant. There are three different types of headaches: tension headaches, cluster headaches, and migraine headaches. Almost 26 percent of pregnant patients will experience tension headaches, a mild-to-moderate pain that is often described as having a tight band around the head. Pain may also be located toward the neck with tension headaches. Cluster headaches are characterized by intense pain, often concentrated around one eye or on one side of the head, and occurring frequently. Cluster headaches are very uncommon in women, occurring less than one percent of the time. A migraine headache is usually unilateral, which means it is concentrated on one side of the head. During pregnancy, about 10 percent of people will have experienced some type of migraine headache. With migraine headaches, an individual may be more sensitive to light, to certain types of noise, and to certain smells. Migraine headaches can also be accompanied by other symptoms, such as nausea. After 20 weeks of pregnancy, careful attention needs to be paid to headaches to ensure they are not a symptom of pre-eclampsia. Headaches associated with pre-eclampsia are usually global tension headaches, occurring all around the head.

What is pre-eclampsia?
While the causes of pre-eclampsia are not understood, the condition may be related to placenta and maternal vascular dysfunction. However, high blood pressure and protein in the urine are the most common signs. In rare cases, the condition causes seizures. If you are experiencing frequent headaches, it is important to have your vitals checked by your physician to see if your blood pressure is elevated. Also, be aware of any headache that is different from what you’ve previously experienced. Changes in vision, such as spots or blurriness, or right upper quadrant abdominal pain or epigastric pain are all signs of pre-eclampsia.

Jian Jenny Tang, MD

What are the best over-the-counter and non-pharmacological treatments for alleviating pregnancy-related headaches?
The first line of treatment recommended is Tylenol®. Patients may take three regular strength Tylenol (975 milligrams total), or two extra strength Tylenol (1000 milligrams total). Tylenol can be taken every six to eight hours, and must not exceed 3000 milligrams per day. This medication is an excellent initial line of over-the-counter treatment for headaches. We do not recommend migraine medicines that you may have been taking pre-pregnancy, such as sumatriptan. Besides Tylenol, caffeine is a great way to help alleviate headaches. Caffeine is fine to use in moderation, and should not exceed 200 milligrams per day. If the headache persists, then the patient should contact their physician. Other non-pharmacological treatments include drinking plenty of fluids to stay well hydrated, keeping your blood glucose levels up by snacking or eating light meals every few hours throughout the day, getting adequate rest, moving to a dark room to avoid light, or placing a damp washcloth over your forehead and relaxing. Other stress reduction or relaxation techniques, such as taking a shower to relax your muscles, listening to soothing music, and aromatherapy can help. Deep mindful breathing and light exercise, such as yoga, are other common non-pharmacological methods that help with headaches. Prevention is key.

How can I prevent pregnancy-related headaches?
Experiencing headaches during pregnancy does not mean you have pre-eclampsia. Other common causes can include dehydration, low blood glucose levels, lack of sleep, and anemia. As such, staying well hydrated and getting enough food and sleep are good ways to prevent headaches. Also, if you consume a lot of caffeinated beverages before pregnancy, abruptly scaling back on caffeine could trigger headaches related to withdrawal. If you plan to give up caffeine, easing yourself off of these beverages gradually can prevent headaches. Your pregnant body is going through a lot of changes, especially during the first trimester. Knowing how to adapt to these rapid changes will help put both your body and mind at ease, so you can focus on your baby.

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Thousands of Mothers Take Part in Mount Sinai Study of COVID-19 and Pregnancy

May 6, 2021 | BFWHRI, COVID-19, Featured, OB/GYN, Pregnancy, Research

Jill Schechter, with baby Jonah, says she was grateful to participate in the study of COVID-19 and pregnancy.

A multidisciplinary team at Mount Sinai is conducting the first large-scale prospective study to examine the impact of COVID-19 infection during pregnancy on maternal and child outcomes. The study is funded by a $1.8 million contract from the Centers for Disease Control and Prevention (CDC) and is expected to be conducted through May 2022. The team calls it “Generation C” because it is studying the maternal experience during the COVID-19 pandemic.

“Early in the pandemic, there were reports that women who tested positive during delivery might have a higher risk of birth complications,” says a co-investigator, Veerle Bergink, MD, PhD, Professor of Psychiatry, and Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai. “We want to know, not only for symptomatic women but also for the asymptomatic women, what exposure to COVID-19 means for your obstetric outcomes and for your baby.”

The research team intends to recruit a cohort of 3,000 pregnant patients at The Mount Sinai Hospital and Mount Sinai West, with more than 2,500 enrolled to date.

One participant in the study is also a co-investigator—Whitney Lieb, MD, MPH, MS, Assistant Professor of Obstetrics, Gynecology and Reproductive Science, Population Health Science and Policy, and Medical Education, Icahn Mount Sinai. “There is limited data about how COVID-19 affects moms and babies, and I think it is important to get as much data as possible,” says Dr. Lieb, who gave birth at Mount Sinai West in July 2020. “That is why I decided to join the study.”

Whitney Lieb, MD, with baby Jacob, is both a participant and a co-investigator in the study. “There is limited data about how COVID-19 affects moms and babies,” says Dr. Lieb, Assistant Professor of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai.

Jill Schechter, who gave birth on Valentine’s Day at The Mount Sinai Hospital, joined for the same reason. Ms. Schechter was vaccinated for COVID-19 while pregnant and asked her physician if there were any studies she could participate in. “I work in health care, and I am aware of the importance of research,” Ms. Schechter says.  “I’m grateful for being able to participate.”

In the study, researchers are examining plasma samples drawn as part of routine care at each trimester of pregnancy in all pregnant women at the two hospitals. Samples are tested for the immunoglobulin M and immunoglobulin G antibodies to SARS-CoV-2, the virus that causes COVID-19, at each trimester of pregnancy and delivery. The team is measuring a panel of inflammatory biomarkers at each trimester of pregnancy and at delivery. The hypothesis is that the level of inflammatory host response to SARS-CoV-2 exposure is related to the impact of the infection on maternal and child outcomes, and that timing is crucial.

The study is examining the subjects’ electronic medical records, obtaining data on obstetric complications, miscarriage, premature rupture of membranes, delivery type, maternal ICU admissions, acute respiratory distress syndrome, sepsis, and maternal death. In addition, the team is extracting data on fetal growth and neonatal outcomes, including birth weight, preterm birth, neonatal morbidities, neonatal intensive care admissions, congenital malformations, and fetal and neonatal death.

“We are looking at the impact and timing of SARS-CoV-2 infection and the development of COVID-19 on these acute and severe complications,” says co-principal investigator Joanne Stone, MD, Director of the Division of Maternal Fetal Medicine, Mount Sinai Health System, and Professor of Obstetrics, Gynecology and Reproductive Science. “The aim is to investigate whether SARS-CoV-2 infection and a strong inflammatory host response are related to preterm delivery and neonatal morbidity.”

Another aim of the study is to examine the extent to which COVID-19 disproportionately impacts pregnant women from underserved communities. This part of the study is taking full advantage of the diversity of Mount Sinai’s patient population. “We have women from the affluent Upper East Side of Manhattan, from the Bronx, from Harlem,” says co-principal investigator Siobhan Dolan, MD, MPH, Vice Chair for Research and Director of Genetics and Genomics, Department of Obstetrics, Gynecology and Reproductive Science, and Co-Director of the Blavatnik Family Women’s Health Research Center. “The ethnic and socioeconomic diversity of our patients means that we do a very good job of reflecting the United States population.”

The World Health Organization classifies pregnant women as at high risk for serious COVID-19-related morbidity and mortality. The Mount Sinai study was proposed in response to a CDC call for research that will bolster the very limited data now available on the effects of SARS-CoV-2. It was designed by Dr. Bergink and Elizabeth Howell, MD, MPP, who is now Chair of Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania.

“This virus will be among us for a while,” Dr. Bergink says, “and it is good to have real-life data on the effects of COVID-19, especially in vulnerable groups, like pregnant women and high-risk populations.”

 

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