Faculty Collaboration Database

Preeclampsia and cognitive impairment later in life. Am J Obstet Gynecol 2017 Jul;217(1):74.e1-74.e11

Date

03/23/2017

Pubmed ID

28322777

Pubmed Central ID

PMC5615406

DOI

10.1016/j.ajog.2017.03.008

Scopus ID

2-s2.0-85017405606 (requires institutional sign-in at Scopus site)   115 Citations

Abstract

BACKGROUND: Hypertension is a risk factor for cerebrovascular disease and cognitive impairment. Women with hypertensive episodes during pregnancy report variable neurocognitive changes within the first decade following the affected pregnancy. However, long-term follow-up of these women into their postmenopausal years has not been conducted.

OBJECTIVE: The aim of this study was to examine whether women with a history of preeclampsia were at increased risk of cognitive decline 35-40 years after the affected pregnancy.

STUDY DESIGN: Women were identified and recruited through the medical linkage, population-based Rochester Epidemiologic Project. Forty women with a history of preeclampsia were age- and parity-matched to 40 women with a history of normotensive pregnancy. All women underwent comprehensive neuropsychological assessment and completed self-report inventories measuring mood, ie, depression, anxiety, and other symptoms related to emotional state. Scores were compared between groups. In addition, individual cognitive scores were examined by neuropsychologists and a neurologist blinded to pregnancy status, and a clinical consensus diagnosis of normal, mild cognitive impairment, or dementia for each participant was conferred.

RESULTS: Age at time of consent did not differ between preeclampsia (59.2 [range 50.9-71.5] years) and normotensive (59.6 [range 52.1-72.2] years) groups, nor did time from index pregnancy (34.9 [range 32.0-47.2] vs 34.5 [range 32.0-46.4] years, respectively). There were no statistically significant differences in raw scores on tests of cognition and mood between women with histories of preeclampsia compared to women with histories of normotensive pregnancy. However, a consensus diagnosis of mild cognitive impairment or dementia trended toward greater frequency in women with histories of preeclampsia compared to those with normotensive pregnancies (20% vs 8%, P = .10) and affected more domains among the preeclampsia group (P = .03), most strongly related to executive dysfunction (d = 1.96) and verbal list learning impairment (d = 1.93).

CONCLUSION: These findings suggest a trend for women with a history of preeclampsia to exhibit more cognitive impairment later in life than those with a history of normotensive pregnancy. Furthermore, the pattern of cognitive changes is consistent with that observed with vascular disease/white matter pathology.

Author List

Fields JA, Garovic VD, Mielke MM, Kantarci K, Jayachandran M, White WM, Butts AM, Graff-Radford J, Lahr BD, Bailey KR, Miller VM

Author

Alissa Butts PhD Associate Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Affect
Aged
Anxiety
Cognitive Dysfunction
Depression
Female
Humans
Hypertension
Middle Aged
Neuropsychological Tests
Pre-Eclampsia
Pregnancy
Self Report