Impact of migraine headaches and depression/anxiety on the incidence of post-dural puncture headache during postpartum course

Abstract

Background Migraine headaches, anxiety disorder and depression have not been studied to determine if parturients are at risk for developing a PDPH. Aims This retrospective analysis is to identify and assess the risk of developing a post-dural puncture headache (PDPH) in parturients with a documented history of primary migraines and anxiety/depression. Methods The parturients who had accidental dural puncture (ADP) during labour epidural placement were included and further analysed for the development of a post-dural puncture headache (PDPH). We compared patient demographics and the history of depression/anxiety, as well as evaluated the patient for a history of migraine headaches and depression/anxiety. Results One hundred seventy-five parturients met our criteria for ADP, from which 92 (52.6 per cent) developed PDPH. A history of migraines was present in 7 of 10 (70 per cent) of patients with a PDPH, from which 4 of 7 (57.1 per cent) required an epidural blood patch treatment. A history of depression/anxiety was found in 7 of 12 (58.3 per cent) with a PDPH of which 2 of 7 (28.6 per cent) required an epidural blood patch treatment. Data analysis showed no significant difference between a history of migraines or depression/anxiety and the incidence of dural puncture headache (P=0.26 and P=0.68, respectively), nor was there an association between a history of migraines or depression/anxiety and the intensity of dural puncture headache (P=0.25 and P=0.63, respectively). Conclusion The results of this study indicate that in postpartum patients neither the presence of a history of migraines nor a history of depression/anxiety was associated with an increased risk of the development of PDPH or an increase in its intensity.