SEATTLE, Sept. 29, 2008 – The National Institute of Child Health and Human Development division of the National Institutes of Health (NIH) has awarded Michelle A. Williams, Sc.D., a $2.9 million grant for a five-year research project to examine possible linkages between the serious pregnancy complication known as preeclampsia and migraine.
Dr. Williams is a co-founder and co-director of Swedish's Center for Perinatal Studies and one of the world's leading authorities on preeclampsia and other pregnancy concerns. She is also a professor of Epidemiology at the University of Washington.
The research project, titled "A Prospective Cohort Study of Migraines, Platelet Activation and Preeclampsia," will be conducted by Dr. Williams and her co-investigator Sheena Aurora, M.D., a migraine specialist with the Swedish Pain and Headache Center. Together they will work with experts at the Puget Sound Blood Center.
The goal of the research is to evaluate whether, and to what extent, a maternal pre-gestational history of migraines and migraine symptoms during early pregnancy are associated with the risk of preeclampsia.
Preeclampsia is a vascular disorder characterized by high blood pressure and the presence of protein in the urine starting around mid-pregnancy. It occurs in up to 8 percent of all pregnancies and, in addition to other hypertensive disorders, is the leading global cause of maternal and infant illness and death.
Migraine is a common chronic-episodic disorder characterized by severe, debilitating headaches. It is often accompanied by nausea and sensitivity to activity and/or external stimuli. Between 14 percent to 25 percent of women suffer from some form of migraine, which is more common during childbearing years.
"There have been a few reports in the medical literature of connections between preeclampsia and migraine," said Dr. Williams. "If we can confirm a definitive link and identify women at higher risk of preeclampsia early enough, then we can monitor them and intervene when necessary."
Starting this fall, Swedish will enroll approximately 2,000 women who are in their first trimester of pregnancy from obstetrics clinics affiliated with the medical center. As part of the study protocol, women who screen positive for migraine or indicate they have experienced it will have a follow-up interview with Dr. Aurora to confirm the diagnosis, and then be interviewed about their medical history. Enrolled women will be followed through to delivery and information will be collected during in-person interviews using study questionnaires.
"We'll collect blood samples during routine prenatal exams, in part, to evaluate the role of platelet aggregation and activation in preeclampsia," said Dr. Williams. "We're trying to go way beyond asking women to self-report and look at specific bio-markers in the blood."
Platelets, a key element of blood clotting, are only activated when needed. For unclear reasons, higher clotting levels have been reported in migraine sufferers and women with preeclampsia. "That suggests a connection, but we need to test that hypothesis thoroughly," Dr. Williams noted. "Only then can we develop conclusions that have medical value and can be acted on."
The research will also evaluate what prescription drugs study subjects take for migraines to determine if there are any clear connections between specific drugs and pregnancy outcomes.
"There is important public health significance to this research," said Tanya Sorensen, M.D., co-director of Swedish's Center for Perinatal Studies. "Migraine is treatable and understanding it better may help clinicians reduce the significant problems associated with preeclampsia."
Earlier this year, Dr. Williams was awarded a $495,554 grant from the March of Dimes Foundation to fund a three-year research project to identify pre-conceptional risk factors and biological markers of preeclampsia and preterm delivery in China.
Swedish is the largest, most comprehensive nonprofit health provider in the Greater Seattle area. It is comprised of three hospital campuses – First Hill, Cherry Hill and Ballard – a freestanding emergency department and specialty center in Issaquah, Home Care Services, and the Swedish Physician Division – a network of about 40 primary-care and specialty clinics located throughout King County. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing specialized treatment in areas such as cardiovascular care, cancer care, neuroscience, orthopedics, high-risk obstetrics, pediatrics, organ transplantation and clinical research. For more information, visit www.swedish.org
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