Grant: Travel Awards - Institute Community Support

Comorbidity, or the presence of 1+ additional chronic conditions (CC), is common with migraine. To inform healthcare services to prevent pregnancy complications and support maternal wellbeing, we identified comorbidity patterns in pregnant individuals with migraine. In a population-based cohort study of pregnancies conceived in 2007-2022 to individuals with migraine in Ontario, Canada, we used latent class analysis (LCA) to identify subgroups using 33 physical and psychiatric CC. Classes were chosen based on statistical fit indices, parsimony, and clinical interpretability. We then compared the sociodemographic and reproductive health-related characteristics of the classes using standardized differences. Of 174,164 pregnant individuals with migraine, 67.2% had 1+ CC. Most prevalent were mood/anxiety disorders (41.4%), low back pain (16.9%), obesity (12.1%), and asthma (10.6%). Three distinct subgroups best characterized comorbidity patterns. Class 1: 'Mood/anxiety disorder' included 81.2% of the cohort, Class 2:'Mood/anxiety disorder and low back pain' 8.3%, and Class 3: 'Other mental illness' 10.6%. The 'Other mental illness' group was younger, lived in lower income neighbourhoods, and had more long-term residents and nulliparous individuals than Class 1, while the 'Mood/anxiety disorder and low back pain comorbidity' group was older and had fewer nulliparous individuals than Class 1. Findings were similar in sensitivity analyses including only CC with at least 1% prevalence. In a LCA using only physical CC, we also identified three latent classes: 'Low back pain' (4.3%), 'Obesity' (2.8%), and 'No physical comorbidity' (92.9%). Identified patterns of comorbidity suggest subgroups who could benefit from preconception and perinatal supports for mental health and chronic pain. Screening for CC and coordinating primary, psychiatric, and obstetric care before or early in pregnancy may aid in early identification and management of migraine-related comorbidities.