Triptans are not commonly used during pregnancy mainly because of the fact that conclusive evidence on their safety profiles is still lacking with only a few studies having been conducted so far.8-11 In one study, the sumatriptan

exposed group was found to be at an increased risk of preterm delivery compared with migraine controls (OR = 6.3; 95% CI: 1.2-32.0) and all pregnant migraineurs who delivered at term were found to be at an increased risk of low birth weight compared with nonmigraine controls (OR = 3.0; 95% CI: 1.3-7.0).9 Pharmaceutical selleck inhibitor company registry studies12,13 have only published a few data on birth defect rates. In these studies, the frequencies of major congenital malformations were reported to be 4.7% for sumatriptan used in 599 pregnancies12 and 3.1% for rizatriptan used in 51 pregnancies;13 these percentages all lie within the normal expected range of birth defect rates for the general population. However, studies based on pharmaceutical company registries are often limited because of a lack of control groups and recall

bias because Compound Library of retrospective reporting and data collection. In general, congenital malformation rates amount to 3.8% in Norway14 2.2% in Europe,14 3.0% in the United States of America15 and 2.8% in Latin America.16 It should, however, be noted Akt inhibitor that these data are not directly comparable, as the inclusion criteria vary between countries. While it is necessary to exercise caution when using pharmacotherapy during pregnancy, untreated or inadequately managed severe migraine may also pose a risk to both the mother and child. Some studies have found a significant association between migraine

and preeclampsia,17-21 and preeclampsia is known to be associated with intrauterine growth retardation and prematurity. An association between migraine during pregnancy and ischemic stroke in the mother has also been found.22 However, the impact of migraine on pregnancy outcome remains uncertain as direct associations between a disease as such and adverse pregnancy outcomes are often difficult to determine. No previous studies on the safety of triptans during pregnancy have taken the possible effect of the underlying disorder into consideration. The main aim of this study was to provide more information on the safety of triptan therapy during pregnancy. More specifically, associations between triptan therapy and congenital malformations, other adverse pregnancy outcomes (including miscarriage/stillbirth, death of the newborn or infant, prematurity, low birth weight and low Apgar scores), and perinatal complications (including atonic uterus, prolonged labor, and extensive maternal blood loss at delivery) were the focus of this study.