{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T21:51:07Z","timestamp":1784843467914,"version":"3.55.0"},"reference-count":45,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Introduction: Migraines are a prevalent neurovascular disorder that affects more than a billion people worldwide. Even though both women and men are affected by this neurological disorder, migraines are primarily recognized as a women\u2019s health disruption factor. Pregnancy leads to significant hormonal changes, including a rise in estrogen, progesterone, and endogeny opioid levels, and, therefore, it can affect the course of migraines. Women dealing with migraines often experience migraine symptom reduction during the course of pregnancy, but in the setting of increased maternal body mass index and obesity, this common pattern may be altered. Due to the complexity of the interplay between pregnancy, obesity, and migraines, all mediated by hormonal changes, the aim of our study is to try to unravel the impact of migraines and obesity on maternal health and pregnancy outcomes. Methods: This study included 350 subjects who have suffered at least one migraine attack three months preceding pregnancy, or at any point during the course of pregnancy. Initially, the study subjects were divided into two groups. The first group included women suffering from migraines before pregnancy, but not during the course of pregnancy, and the other group included all subjects who remained symptomatic during the course of pregnancy or had a first migraine attack during their pregnancy. Further comparisons were made based on the patients\u2019 BMI values, and correlations were made between the obese and non-obese study subjects. Results: Higher parity (p = 0.005), obesity (p = 0.005), earlier age of migraine onset (p = 0.004), and gestational diabetes mellitus (p = 0.004) were statistically significant predictors for migraine symptom persistence during pregnancy. Obese pregnant women were more likely to experience migraine intensity and frequency persistence during pregnancy (p &lt; 0.001 and p &lt; 0.001, respectively). They sought magnesium treatment more often (p &lt; 0.001), but this had a modest therapeutic effect compared to non-obese pregnant women (p &lt; 0.001). A diagnosis of hypertensive disorder of pregnancy and gestational diabetes mellitus was also more frequently established in the group of obese pregnant women (p = 0.002 and p &lt; 0.001, respectively). Conclusions: Pregnancy induces substantial physiological changes that can both alleviate and exacerbate migraine symptoms. Obesity is a modifiable risk factor that not only may increase the intensity and frequency of migraine symptoms, but may also compromise pregnancy course and outcome. The co-occurrence of migraines and obesity during pregnancy may amplify health risks for the mother and fetus, including heightened susceptibility to gestational diabetes mellitus. Future research should prioritize focusing on better understanding the causal relationships between pregnancy, migraines, and obesity and providing treatment strategies the home in on weight management and the control of migraine symptoms and associated comorbidities.<\/jats:p>","DOI":"10.3390\/life15071014","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T03:39:59Z","timestamp":1750909199000},"page":"1014","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Migraines, Obesity, and Pregnancy: Who Is the Villain and Who Is the Victim?"],"prefix":"10.3390","volume":"15","author":[{"given":"Milan","family":"Lackovic","sequence":"first","affiliation":[{"name":"Harris Birthright Research Centre for Fetal Medicine, King\u2019s College Hospital, London SE5 8BB, UK"},{"name":"Department of Obstetrics and Gynecology, University Hospital \u201cDragisa Misovic\u201d, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sladjana","family":"Mihajlovic","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital \u201cDragisa Misovic\u201d, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jovana","family":"Kuzmanovic Pficer","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics and Informatics, Faculty of Dentistry, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Hristov","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospital \u201cDragisa Misovic\u201d, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0595-9881","authenticated-orcid":false,"given":"Zagorka","family":"Milovanovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Clinic for Gynecology and Obstetrics \u201cNarodni Front\u201d, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivona","family":"Jovanovic","sequence":"additional","affiliation":[{"name":"Clinic for Gynecology and Obstetrics \u201cNarodni Front\u201d, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0609-9916","authenticated-orcid":false,"given":"Dejan","family":"Nikolic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Department of Physical Medicine and Rehabilitation, University Children\u2019s Hospital, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1016\/S0140-6736(20)32160-7","article-title":"Migraine: Epidemiology and systems of care","volume":"397","author":"Ashina","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s10072-020-04643-8","article-title":"Gender-related differences in migraine","volume":"41","author":"Allais","year":"2020","journal-title":"Neurol. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1526-4610.2006.00309.x","article-title":"Ovarian hormones and migraine headache: Understanding mechanisms and pathogenesis\u2014Part I","volume":"46","author":"Martin","year":"2006","journal-title":"Headache"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.pharmthera.2006.08.009","article-title":"Potential role of female sex hormones in the pathophysiology of migraine","volume":"113","author":"Gupta","year":"2007","journal-title":"Pharmacol. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/S1474-4422(20)30482-8","article-title":"Menstrual migraine: A distinct disorder needing greater recognition","volume":"20","author":"Vetvik","year":"2021","journal-title":"Lancet Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1038\/sj.bjp.0703164","article-title":"Differential effects of 17beta-estradiol and testosterone on the contractile responses of porcine coronary arteries","volume":"129","author":"Teoh","year":"2000","journal-title":"Br. J. Pharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Rivera-Mancilla, E., Al-Hassany, L., Villal\u00f3n, C.M., and MaassenVanDenBrink, A. (2021). Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.686398"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Pavlovic, J.M., Vieira, J.R., Lipton, R.B., and Bond, D.S. (2017). Association Between Obesity and Migraine in Women. Curr. Pain. Headache Rep., 21.","DOI":"10.1007\/s11916-017-0634-8"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Lackovic, M., Filimonovic, D., Mihajlovic, S., Milicic, B., Filipovic, I., Rovcanin, M., Dimitrijevic, D., and Nikolic, D. (2020). The Influence of Increased Prepregnancy Body Mass Index and Excessive Gestational Weight Gain on Pregnancy Course and Fetal and Maternal Perinatal Outcomes. Healthcare, 8.","DOI":"10.3390\/healthcare8040362"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lackovic, M., Nikolic, D., Milicic, B., Dimitrijevic, D., Jovanovic, I., Radosavljevic, S., and Mihajlovic, S. (2024). Pre-Pregnancy Obesity and Infants\u2019 Motor Development within the First Twelve Months of Life: Who Is Expected to Be the Ultimate Carrier of the Obesity Burden?. Nutrients, 16.","DOI":"10.3390\/nu16091260"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s10072-019-03792-9","article-title":"Migraine during pregnancy and in the puerperium","volume":"40","author":"Allais","year":"2019","journal-title":"Neurol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s10194-011-0329-1","article-title":"Headache and migraine during pregnancy and puerperium: The MIGRA-study","volume":"12","author":"Kvisvik","year":"2011","journal-title":"J. Headache Pain"},{"key":"ref_13","first-page":"e1464","article-title":"Prepregnancy Migraine, Migraine Phenotype, and Risk of Adverse Pregnancy Outcomes","volume":"100","author":"Stuart","year":"2023","journal-title":"Neurology"},{"key":"ref_14","unstructured":"(1988). Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia, 8, 1\u201396."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.bpobgyn.2016.08.003","article-title":"Macrosomia","volume":"38","author":"Peixoto","year":"2017","journal-title":"Best. Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Verfaille, V., de Jonge, A., Mokkink, L., Westerneng, M., van der Horst, H., Jellema, P., Franx, A., and IRIS study group (2017). Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands. BMC Pregnancy Childbirth, 17.","DOI":"10.1186\/s12884-017-1513-3"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S254","DOI":"10.2337\/dc23-S015","article-title":"on behalf of the American Diabetes Association. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes-2023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"16","DOI":"10.48208\/HeadacheMed.2021.4","article-title":"The association between obesity and migraine and possible mechanisms of action: An integrative literature review","volume":"12","author":"Halaiko","year":"2021","journal-title":"Headache Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1111\/j.1526-4610.2010.01833.x","article-title":"Body mass index and adult weight gain among reproductive age women with migraine","volume":"51","author":"Vo","year":"2011","journal-title":"Headache"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Abo, S., Smith, D., Stadt, M., and Layton, A. (2022). Modelling female physiology from head to Toe: Impact of sex hormones, menstrual cycle, and pregnancy. J. Theor. Biol., 540.","DOI":"10.1016\/j.jtbi.2022.111074"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Niebrzydowska-Tatus, M., Pe\u0142ech, A., Rekowska, A.K., Satora, M., Masiarz, A., Kaba\u0142a, Z., Kimber-Trojnar, \u017b., and Trojnar, M. (2024). Recent Insights and Recommendations for Preventing Excessive Gestational Weight Gain. J. Clin. Med., 13.","DOI":"10.3390\/jcm13051461"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.2147\/DMSO.S447781","article-title":"Migraine Duration as a Potential Amplifier of Obesity","volume":"17","author":"Fan","year":"2024","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lackovic, M., Jankovic, M., Mihajlovic, S., Milovanovic, Z., Rovcanin, M., Mitic, N., and Nikolic, D. (2024). Gestational Weight Gain, Pregnancy Related Complications and the Short-Term Risks for the Offspring. J. Clin. Med., 13.","DOI":"10.3390\/jcm13020445"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1111\/head.13665","article-title":"Epidemiology and Treatment of Menstrual Migraine and Migraine During Pregnancy and Lactation: A Narrative Review","volume":"60","author":"Burch","year":"2020","journal-title":"Headache"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1038\/ijo.2017.159","article-title":"Obesity during pregnancy affects sex steroid concentrations depending on fetal gender","volume":"41","author":"Maliqueo","year":"2017","journal-title":"Int. J. Obes."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.cyto.2009.05.004","article-title":"Maternal obesity and markers of inflammation in pregnancy","volume":"47","author":"Madan","year":"2009","journal-title":"Cytokine"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1038\/nature05485","article-title":"Inflammation and metabolic disorders","volume":"444","author":"Hotamisligil","year":"2006","journal-title":"Nature"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1674S","DOI":"10.1093\/jn\/133.5.1674S","article-title":"Gestational diabetes and insulin resistance: Role in short- and long-term implications for mother and Fetus","volume":"133","author":"Catalano","year":"2003","journal-title":"J. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1113\/JP284139","article-title":"Obesity and gestational diabetes independently and collectively induce specific effects on placental structure, inflammation and endocrine function in a cohort of South African women","volume":"601","author":"Musa","year":"2023","journal-title":"J. Physiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.dsx.2021.03.018","article-title":"A systematic literature review of observational studies of the bilateral association between diabetes and migraine","volume":"15","author":"Hosseinpour","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"164","DOI":"10.3988\/jcn.2021.17.2.164","article-title":"The Role of Endothelial Dysfunction in the Pathophysiology and Cerebrovascular Effects of Migraine: A Narrative Review","volume":"17","author":"Paolucci","year":"2021","journal-title":"J. Clin. Neurol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Barbu, E., Popescu, M.R., Popescu, A.C., and Balanescu, S.M. (2022). Inflammation as A Precursor of Atherothrombosis, Diabetes and Early Vascular Aging. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23020963"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Mart\u00ednez-Mart\u00ednez, E., Souza-Neto, F.V., Jim\u00e9nez-Gonz\u00e1lez, S., and Cachofeiro, V. (2021). Oxidative Stress and Vascular Damage in the Context of Obesity: The Hidden Guest. Antioxidants, 10.","DOI":"10.3390\/antiox10030406"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Palatnik, A., and Kulinski, J. (2024). Hypertensive disorders of pregnancy & vascular dysfunction. Front. Cardiovasc. Med., 11.","DOI":"10.3389\/fcvm.2024.1411424"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1016\/j.jacc.2022.03.335","article-title":"Cardiovascular Risk Factors Mediate the Long-Term Maternal Risk Associated With Hypertensive Disorders of Pregnancy","volume":"79","author":"Stuart","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Fuglsang, C.H., Pedersen, L., Schmidt, M., Vandenbroucke, J.P., B\u00f8tker, H.E., and S\u00f8rensen, H.T. (2024). Combined Impact of Migraine and Pregnancy-Induced Hypertension on Long-term Risk of Premature Myocardial Infarction and Stroke. Neurology, 102.","DOI":"10.1212\/WNL.0000000000207813"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Wang, K., Mao, Y., Lu, M., Ding, Y., Li, Z., Li, Y., Liu, X., Sun, Y., Hong, J., and Xu, D. (2022). Association between migraine and cardiovascular disease: A cross-sectional study. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.1044465"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1111\/j.1526-4610.2006.00444.x","article-title":"Migraine changes with age: IMPACT on migraine classification","volume":"46","author":"Kelman","year":"2006","journal-title":"Headache"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1212\/01.wnl.0000225186.76323.69","article-title":"Age-dependent prevalence and clinical features of migraine","volume":"67","author":"Bigal","year":"2006","journal-title":"Neurology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1002\/clc.22887","article-title":"Adverse pregnancy outcomes and future maternal cardiovascular disease","volume":"41","author":"Hauspurg","year":"2018","journal-title":"Clin. Cardiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1177\/2047487318818265","article-title":"Parity and risk of maternal cardiovascular disease: A dose-response meta-analysis of cohort studies","volume":"26","author":"Li","year":"2019","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1111\/j.1526-4610.2009.01438.x","article-title":"The effect of pregnancy and parity on headache prevalence: The Head-HUNT study","volume":"49","author":"Aegidius","year":"2009","journal-title":"Headache"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bugge, N.S., Gr\u00f8tta Vetvik, K., Alstadhaug, K.B., and Braaten, T. (2024). Cumulative exposure to estrogen may increase the risk of migraine in women. Cephalalgia, 44.","DOI":"10.1177\/03331024231225972"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"23905","DOI":"10.3390\/ijms161023905","article-title":"Cardiovascular Complications of Pregnancy","volume":"16","author":"Gongora","year":"2015","journal-title":"Int. J. Mol. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Lackovic, M., Jankovic, M., Mihajlovic, S., Milovanovic, Z., and Nikolic, D. (2023). Exploring the Connection between Migraines and Pregnancy: The Impact of Physical Activity on Symptom Management. Medicina, 60.","DOI":"10.3390\/medicina60010049"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/7\/1014\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:58:45Z","timestamp":1760032725000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/7\/1014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":45,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["life15071014"],"URL":"https:\/\/doi.org\/10.3390\/life15071014","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,25]]}}}