Pre-eclampsia poses no increased risk of neurocognitive impairment
Women who have had pre-eclampsia do not exhibit clear neurocognitive impairment years after the index pregnancy, a study suggests.
Researchers used data from the Coronary Artery Risk Development in Young Adults cohort and looked at 568 parous women, of whom 193 had pre-eclampsia and 375 had normotensive pregnancy, without neurological disease or depression at baseline. Assessments included psychomotor speed (Digit Symbol Substitution Test), executive function (Stroop Test) and memory (Rey Auditory Verbal Learning Test).
Around 18 years after delivery, women in the pre-eclampsia group scored significantly lower on Digit Symbol Substitution Test (73.21 vs 75.87; p=0.047) and on the third trial of Stroop Test (correct answers: 38.85 vs 39.42; p=0.014; completion time: 44.02 vs 41.62 seconds; p=0.01) relative to those in the normotensive pregnancy group. Results for the Rey Auditory Verbal Learning Test did not significantly differ between the two groups.
However, the differences in psychomotor speed and executive function were attenuated after controlling for age, body mass index, hypertension, education and depression. Similar differences in neurocognitive scores were observed between women with other hypertensive disorders of pregnancy and normotensive pregnancy.
Evidence suggests that women with pre-eclampsia who indicate more anxiety and more depressive symptoms may be more vulnerable for cognitive failures in complex and perhaps more stressful daily life conditions. This is because executive functioning, or the control of complex, goal-directed behaviour is the cognitive ability most susceptible to stress. [Am J Obstet Gynecol 2014;211:37.e1-37.e9; Accid Anal Prev 2012;49:532-535]
Additional studies focusing on the relationship between subjective and objective neurocognitive functioning, symptoms of anxiety and depression, and brain white matter lesions are warranted.