Key takeaways:

• Gestational hypertension was tied to maternal decline in processing speed and executive functioning after age 45 years.
• Preeclampsia and eclampsia were not associated with any type of neurocognitive decline.

Among Hispanic women, gestational hypertension was associated with decreased processing speed and executive functioning after age 45 years, according to results of an analysis published in Obstetrics & Gynecology.

“Women who experienced gestational hypertension during pregnancy showed decreased processing speed/executive functioning later in life, suggesting that gestational hypertension may be an independent risk factor for maternal cognitive decline later in life,” Shathiyah Kulandavelu, PhD, research assistant professor in the department of pediatrics at the Interdisciplinary Stem Cell Institute at the University of Miami Miller School of Medicine, told Healio. “Women with pregnancies complicated by hypertensive disorders of pregnancy, especially those with gestational hypertension, could benefit from closer monitoring of cognitive status, along with promotion of greater education attainment and healthy lifestyles changes to prevent and/or delay future cognitive impairment.”

Kulandavelu, along with co-author Tali Elfassy, PhD, a research assistant professor in the department of medicine at the Peggy and Harold Katz Family Drug Discovery Center at the University of Miami Miller School of Medicine, and colleagues conducted an analysis of 3,554 parous women (mean age, 56.2 years) aged 45 years or older from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective population-based study of Hispanic/Latino women from four communities in the U.S. All women completed the neurocognitive assessment from 2008 to 2011 and a repeat assessment from 2015 to 2018 and self-reported any gestational hypertension, preeclampsia or eclampsia. Researchers measured cognitive functioning with the Brief Spanish-English Verbal Learning Test (B-SEVLT), Digit Symbol Substitution Test (DSST) and Word Fluency Test.

Of the 13.4% of women who reported at least one hypertensive disorder of pregnancy, 11% had gestational hypertension, 4.9% had preeclampsia and 1.2% had eclampsia.

Tali Elfassy

Women with hypertensive disorders of pregnancy were more likely to have higher mean systolic blood pressure (129.8 vs. 127 mm Hg; P = .03), fasting glucose (115.6 vs. 105.5 mg/dL; P = .02) and BMI (32.3 vs. 30.2 kg/m²; P < .01) compared with women without. After an average of 6.9 years of follow-up, gestational hypertension was associated with a 0.17 standard deviation decline in DSST scores, which measures processing speed and executive functioning. Gestational hypertension was not associated with changes in B-SEVLT or Word Fluency Test scores.

Both preeclampsia and eclampsia were not associated with differences in neurocognition over time.

“The next step will be to elucidate different mechanisms that may be involved during pregnancy and/or postdelivery, which may contribute to faster cognitive decline in these women later in life,” Kulandavelu said. “Also, as cognitive decline is a process that can take decades, a longer follow-up of these women may identify further cognitive decline.”