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Abstract
Objective To determine the association between hypertensive disorders of pregnancy (HDP) and cognitive impairment 15 years after pregnancy, we measured cognitive performance in 115 women with a history of HDP and in 481 women with a previous normotensive pregnancy.
Methods This was a nested cohort study embedded in a population-based prospective cohort from early pregnancy onwards. Cognitive function was assessed with cognitive tests 15 years after the index pregnancy (median 14.7 years, 90% range [13.9–16.1]). Cognitive performance was measured in different cognitive domains: executive function, processing speed, verbal memory, motor function, and visuospatial ability. A global cognition factor (g-factor) was derived from principal component analysis.
Results Of the women with HDP, 80 (69.6%) had gestational hypertension (GH) and 35 (30.4%) had preeclampsia. Women with HDP had a lower g-factor than women with a previous normotensive pregnancy (mean −0.22, 90% range [−2.06−1.29]). HDP was negatively associated with the 15-word learning test: immediate recall (−0.25, 95% CI [−0.44 to −0.06]) and delayed recall (−0.30, 95% CI [−0.50 to −0.10]). Women with GH perform significantly worse on their 15-word learning test than women with a previous normotensive pregnancy.
Conclusion A history of HDP is independently associated with poorer working memory and verbal learning 15 years after pregnancy. This association is mainly driven by women with GH. Clinicians and women who experienced HDP should be aware of this risk.
Glossary
- 15WLT=
- 15-word learning test;
- BMI=
- body mass index;
- CVD=
- cardiovascular disease;
- DBP=
- diastolic blood pressure;
- GH=
- gestational hypertension;
- g-factor=
- global cognition factor;
- HDP=
- hypertensive disorders of pregnancy;
- MEC=
- medical ethical committee;
- SBP=
- systolic blood pressure;
- SDS=
- SD scores
Footnotes
Go to Neurology.org/Nhttps://n.neurology.org/lookup/doi/10.1212/WNL.0000000000011363 for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 193
CME Course: NPub.org/cmelist
- Received May 22, 2020.
- Accepted in final form September 4, 2020.
- © 2020 American Academy of Neurology
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