Abstract
Introduction: Previous research has shown cognitive decline related to preeclampsia (preE) in women after pregnancy when using neurocognitive assessments; however, it is not known if changes in cognition occur antenatally (e.g., in the third trimester of pregnancy). This pilot study investigated if the cerebrovascular effect of preE can manifest as cognitive decline antenatally. Hypothesis: Pregnant preE women will score lower on cognitive tests in the executive and memory function domains compared with pregnant normotensive women. Methods: This was a prospective observational study in a single institution. We included women more than 28 weeks of gestation with preE or normotension. We excluded women with chronic hypertension, neurologic and developmental disabilities, and current substance use. Neurocognitive test battery included subjective (Everyday Cognition) and objective assessment of executive function (Stroop test, Trail Making), attention and working memory (Digit Span Subtest), and information processing speed (Digit Symbol Substitution) evaluated as z-scores. Baseline characteristics (e.g. pre-pregnancy Body mass index [BMI]) characteristics were collected. Results: We enrolled 1 to 2 women weekly over 4 months. Thirty pregnant women were included (16 preE; 14 normotensive). Those with preE had higher pre-pregnancy BMI, delivered at earlier gestational age and reported higher history of migraines. PreE vs. normotensive women had more memory complaints (p<0.001) and scored lower on objective measures of information processing speed, attention, and the executive function of inhibition ( Table ). Conclusions: Assessment of cognition in pregnant preE and normotensive women is feasible. PreE women reported worse subjective memory, and had lower scores in attention, information processing speed, and the executive function. Future work to determine if these cognitive differences persist postpartum is warranted.
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