The influence of migraine on cognitive functioning, sleep quality and mental health outcomes in postpartum women, with and without hypertensive disorders of pregnancy: a cross-sectional study

Cognitive impairment in early postpartum women is a prevalent phenomenon due to numerous cognitive, physiological, and psychological stressors, with comorbidities such as migraine and hypertensive disorders of pregnancy (HDP) potentially further exacerbating these impairments. Migraine, which is a neurovascular disease affecting a considerable number of women of reproductive age, has pathophysiological overlap with hypertensive disorders of pregnancy (HDP), particularly in vascular damage affecting cognitive functioning. To our knowledge, there is currently no literature examining cognitive impairment during the early postpartum period in this specific population. Therefore, this cross-sectional study assessed the influence of migraine on cognitive functioning, sleep quality, and mental well-being in postpartum women with and without HDP up to 12 months postpartum. Cognitive tests covered verbal memory, executive functioning, processing speed, verbal fluency, motor coordination, and visuospatial functions. Sleep quality and depression status were assessed through PSQI and CES-D scales. Data were analyzed using multivariate linear regression analysis with and without controlling for a subset of confounders and stratified by HDP status. In total, 233 postpartum women were included. No differences were found in any measure of cognition, sleep quality, or depression between those women with and without migraine. The lack of difference indicates that having migraine, which is a chronic condition, does not impose additional cognitive, sleep-related, or psychological burden to women within the first year postpartum other than what is typical of them as a group. These findings may provide a clinical basis for reassurance to women suffering from migraine, especially those who also experienced HDP.