Hypertensive Disorders of Pregnancy Heightens the Risk for Maternal Dementia and Poor Cognition

Hypertensive disorders of pregnancy (HDP), including preeclampsia, are linked to an increased risk of maternal cardiovascular disease, stroke, and chronic kidney disease. However, their association with later-life maternal dementia or cognitive impairment is less understood. 

The objective of a recent study was to review and synthesize existing literature on the relationship between hypertensive disorders during pregnancy and the subsequent risk of maternal dementia or cognitive decline.

This systematic search and meta-analysis entailed a comprehensive search from PubMed, Web of Science, Psychinfo, and CINAHL databases – up to July 31, 2022––focusing on observational studies examining HDP and outcomes related to dementia or cognitive impairment. Studies included pregnant women exposed to HDP with at least one primary outcome of dementia or a secondary outcome of cognitive impairment. The review process followed the Meta-analyses of Observational Studies in Epidemiology guidelines.

The analysis included 25 studies with a total of 2,501,673 women. It was found that preeclampsia was significantly associated with an increased risk of vascular dementia. However, no strong association was found between preeclampsia and Alzheimer's disease or undifferentiated dementia. In women aged 65 and older, preeclampsia was linked to a higher risk of both Alzheimer's disease and any form of dementia.

The results indicated that women with a history of preeclampsia appear to be at a significantly greater risk for vascular dementia. The long-term risks for Alzheimer’s and other forms of dementia are less clear, necessitating further high-quality research with extended follow-up to better understand these associations. In addition, women with HDP may experience poorer cognitive performance, particularly in working memory and attention, later in life, although the clinical relevance of these findings remains uncertain.

Source: Carey C, Mulcahy E, McCarthy FP, et al. American Journal of Obstetrics and Gynecology. 2024 Jan 24.