TY - JOUR
T1 - Preeclampsia and cognitive impairment later in life
AU - Fields, Julie A.
AU - Garovic, Vesna D.
AU - Mielke, Michelle M.
AU - Kantarci, Kejal
AU - Jayachandran, Muthuvel
AU - White, Wendy M.
AU - Butts, Alissa M.
AU - Graff-Radford, Jonathan
AU - Lahr, Brian D.
AU - Bailey, Kent R.
AU - Miller, Virginia M.
N1 - Publisher Copyright:
© 2017 The Authors
PY - 2017/7
Y1 - 2017/7
N2 - 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.
AB - 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.
KW - cardiovascular disease
KW - cerebrovascular disease
KW - cognition
KW - dementia
KW - hypertensive pregnancy
KW - mild cognitive impairment
KW - preeclampsia
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U2 - 10.1016/j.ajog.2017.03.008
DO - 10.1016/j.ajog.2017.03.008
M3 - Article
C2 - 28322777
AN - SCOPUS:85017405606
SN - 0002-9378
VL - 217
SP - 74.e1-74.e11
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 1
ER -