Hypertensive disorders of pregnancy and midlife maternal cognition in a prospective cohort study

Kate Birnie*, Janet Catov, Emma L Anderson, Winok Lapidaire, Fanny C Kilpi, Deborah A Lawlor, Abigail Fraser

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of cardiovascular disorders, with recent evidence linking pre-eclampsia with vascular dementia. We examined associations of HDP with cognitive performance measured in midlife, in a prospective cohort study, the Avon Longitudinal Study of Parents and Children. Six cognitive function domains were measured 20 years after pregnancy at a mean age of 51 years. The cognition tests were repeated at clinics in the following two years. Cognitive function domains measured were immediate and delayed verbal episodic memory, working memory, processing speed, verbal intelligence, and verbal fluency. Exposures were pre-eclampsia, gestational hypertension (GH), and a combined category of any HDP, all compared to normotensive pregnancy. Of 3393 pregnancies included in the analysis, GH was experienced by 417 (12.3%) and pre-eclampsia by 57 (1.7%). GH was associated with lower verbal episodic memory, in the delayed logic memory test (-0.16 SDs; 95% CI -0.30, -0.03; p = .015) and there was weak evidence of an association with the immediate logic memory test (-0.13 SDs; -0.27, 0.001; p = .058). However, we did not see steeper declines by age for women with GH and there was no evidence of associations with other cognitive domains or for pre-eclampsia with any domains. Results were not substantially changed after controlling for midlife blood pressure. Our findings suggest that a history of GH is associated with slightly reduced episodic memory 20 years after pregnancy, but we found no evidence of a quicker age-related decline compared to women with normotensive pregnancies.
Original languageEnglish
Pages (from-to)166-176
Number of pages11
JournalJournal of Clinical Hypertension
Volume26
Issue number2
Early online date12 Jan 2024
DOIs
Publication statusPublished - 9 Feb 2024

Bibliographical note

Funding Information:
Deborah A. Lawlor has received funding from Medtronic Ltd and Roche Diagnostics for research unrelated to this project.

Funding Information:
The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and Kate Birnie will serve as guarantor for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant‐acknowledgements.pdf ); This research was specifically funded by the British Heart Foundation (Grant Ref: SP/07/008/24066, PG/19/21/34190, CH/F/20/90003 and AA/18/7/34219), Wellcome Trust (Grant Ref: WT092830/Z/10/Z), and Lifelong Health and Wellbeing (LLHW) via the MRC (Grant reference G1001357). Abigail Fraser and Deborah A. Lawlor work in the Medical Research Council Integrative Epidemiology Unit at the University of Bristol which is supported by the Medical Research Council and the University of Bristol (MC_UU_00011/1 and MC_UU_00011/6). The funders had no role in designing the study, collecting or analyzing data, or contributing to writing the paper. The views expressed in this paper are those of the authors and not necessarily any funding body.

Publisher Copyright:
© 2024 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC.

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