Neurocognitive functioning following preeclampsia and eclampsia: a long-term follow-up study

Ineke Rixt Postma; Anke Bouma; Iefke Froukje Ankersmit; Gerda Geertruida Zeeman

doi:10.1016/j.ajog.2014.01.042

Neurocognitive functioning following preeclampsia and eclampsia: a long-term follow-up study

Am J Obstet Gynecol. 2014 Jul;211(1):37.e1-9. doi: 10.1016/j.ajog.2014.01.042. Epub 2014 Feb 1.

Authors

Ineke Rixt Postma¹, Anke Bouma², Iefke Froukje Ankersmit², Gerda Geertruida Zeeman¹

Affiliations

¹ Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
² Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.

PMID: 24495666
DOI: 10.1016/j.ajog.2014.01.042

Abstract

Objective: Women who suffered preeclampsia and eclampsia may report subjective cognitive difficulties in daily life, the interpretation of which is cumbersome, because these are affected by emotional factors. Previous studies only included preeclamptic women investigated shortly after pregnancy. We aimed to determine whether these subjective reports of cognitive difficulty could be interpreted as reflecting objective cognitive dysfunction. Therefore, cognitive functioning was assessed using standardized neurocognitive tests in both preeclamptic and eclamptic women several years following the index pregnancy.

Study design: Forty-six formerly eclamptic, 51 formerly preeclamptic, and 48 control women who had normotensive pregnancies, age-matched, participated in this study. Average elapsed time since index pregnancy was 7 years. Neurocognitive tests were divided into 6 domains; visual perception, motor functions, working memory, long-term memory, attention, and executive functioning. Subjective cognitive functioning was measured by the Cognitive Failures Questionnaire and anxiety/depression by the Hospital Anxiety and Depression Scale.

Results: Both preeclamptic and eclamptic women performed worse on the motor functions domain (P < .05), without differences on the other domains. They scored worse on the Cognitive Failures Questionnaire (P < .01), the Hospital Anxiety and Depression Scale anxiety (P < .01), and depression (P < .05) subscales.

Conclusion: Women who suffered eclampsia and/or preeclampsia demonstrate no objective cognitive impairment as compared with controls. Contrary to the well-structured test setting, both groups do report more cognitive failures, which are thought to reflect neurocognitive dysfunction in complex, stressful daily-life situations. Such report of cognitive failures may be compounded by anxiety and depression. Future studies should focus on the relationship of neurocognitive functioning with structural cerebral abnormalities.

Keywords: anxiety and depression; cognitive complaints; eclampsia; neurocognitive functioning; preeclampsia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety / diagnosis
Anxiety / etiology
Case-Control Studies
Cognition Disorders / diagnosis
Cognition Disorders / etiology*
Depression / diagnosis
Depression / etiology
Eclampsia / physiopathology
Eclampsia / psychology*
Female
Follow-Up Studies
Humans
Linear Models
Multivariate Analysis
Neuropsychological Tests
Pre-Eclampsia / physiopathology
Pre-Eclampsia / psychology*
Pregnancy
Psychiatric Status Rating Scales
Psychomotor Disorders / etiology
Self Report
Surveys and Questionnaires