Mental health screening is crucial to identifying long-term cognitive issues in affected mothers.
Having preeclampsia may predispose women to difficulties with memory and behavioural regulation up to 20 years after giving birth, according to new international research.
Dutch researchers analysed hospital data from 1500 mothers and found those with a history of preeclampsia were over nine times more likely to experience weakened executive cognitive function, defined as cognitive processes involved with regulation of emotional responses and behaviour, in the first months after pregnancy.
The results, published in the American Journal of Obstetrics and Gynecology, also showed that these effects could last up to 19 years postpartum. In addition, up to half of mothers who had preeclampsia experienced ongoing difficulties with working memory, compared to only 6% of women who had normotensive pregnancies.
Commenting on the study, Australian obstetrician Associate Professor Amanda Henry said the magnitude of the cognitive changes was surprising.
“Preeclampsia can have lasting effects on women’s health, and it’s important to monitor physical and mental health and overall functioning of patients who’ve experienced preeclampsia,” she told TMR.
The authors also observed that mothers with preeclampsia had a 16% future risk of weakened behavioural regulation, and a 30% risk of worsened metacognition shortly after giving birth, compared to 1% and 6% respectively of women who had uncomplicated pregnancies.
Multiple factors could be behind the persistent cognitive issues said Professor Henry, who is also associate professor of obstetrics and gynaecology at the University of NSW.
These included underlying mood and anxiety disorders and trauma resulting from a difficult pregnancy and birth in the short term. More long-term, Professor Henry said that vascular conditions, such as high blood pressure and type two diabetes, associated with preeclampsia were known to affect cognitive function.
Although risks of weakened cognitive function gradually subsided for all mothers, those who experienced complicated pregnancies with preeclampsia had higher risks of limitations to processes regarding starting tasks and problem-solving for up to 19 years after giving birth.
Women with preeclampsia also experienced limitations with working memory and task monitoring up to 23 years after giving birth, while difficulties with planning and organising continued up to 15 years for some mothers.
Professor Henry highlighted several limitations to the study’s findings, including a reliance on self-reporting and the use of overall scales rather than standardised diagnostic tests to assess cognitive function.
However, she also said the findings emphasised the importance of regularly monitoring mental as well as physical health in patients with a history of preeclampsia.
“Mood disorders and traumatic experiences can affect things like emotional regulation and memory, so if we’re screening for those and referring patients for counselling and possibly pharmacotherapy if issues are identified, then that can [also] be helpful,” she said.
According to the study’s authors, greater levels of detection and support were needed to combat preeclampsia’s potentially harmful effect on cognitive function in the months and decades after pregnancy.
“A concerningly high number of women experience clinically relevant executive dysfunction after preeclampsia in the prime of their life. As cognitive problems profoundly affect personal control, social interactions and work performance, more attention is needed to detect and support affected women,” they concluded.
American Journal of Obstetrics and Gynecology 2023, online 28 February
