Gestational Hypertension, Preeclampsia, and Eclampsia Associated With Greater Incidence of Future Neurological Disorders
A recent Swedish cohort study of primiparous women found that those who experienced gestational hypertension, preeclampsia, and eclampsia were at increased risk for new-onset neurological disorders months or years after giving birth. Findings were published in JAMA Neurology.
“In this study, women with gestational hypertension, preeclampsia, and eclampsia had an association with 20% to 70% increased risk of developing neurological disorders (migraine, headache, epilepsy, sleep disorder, or mental fatigue) in the years following their first birth,” said Therese Friis, MD, Uppsala University, Sweden, and co-authors. “When investigating the neurological outcomes individually, the strongest association was found between women with eclampsia and epilepsy, with a 5-fold increased risk compared with women with a normotensive pregnancy.”
Authors utilized the Swedish Medical Birth Register to gather data from 648,385 first-time mothers with singleton pregnancies between 2005 and 2018, with follow-up enabled using the National Patient Register. Women with pre-existing hypertension or neurological disorders were excluded. Risk was calculated with Cox regression analysis.
The findings revealed that gestational hypertension, preeclampsia, and eclampsia were linked to an increased risk of developing new-onset neurological disorders, including migraine, headache, epilepsy, sleep disorders, and mental fatigue, up to 15 years postpartum. Specifically, the adjusted hazard ratios (aHR) were 1.27 (95% CI, 1.12-1.45) for gestational hypertension, 1.32 (95% CI, 1.22-1.42) for preeclampsia, and 1.70 (95% CI, 1.16-2.50) for eclampsia. Notably, eclampsia was associated with more than a fivefold increased risk of epilepsy (aHR, 5.31; 95% CI, 2.85-9.89).
“Guidelines recommend follow-up after delivery for women with gestational hypertension and preeclampsia for their increased risk of cardiovascular disease. At these visits, caregivers should also pay attention to persisting or new-onset of neurological symptoms, since this group of women appears to be vulnerable to developing or experiencing neurological disorders,” study authors recommended based on study results.
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