Self-Reported Cognitive Functioning in Formerly Eclamptic Women

Abstract

While the pathophysiology of eclampsia remains enigmatic, one view is that it is an expression of hypertensive encephalopathy. Although white matter lesions have been found in eclamptic women imaged 6 weeks after delivery, and similar lesions with other etiologies have been associated with cognitive impairment, information about cognitive functioning after eclampsia is limited. This study used a validated cognitive failures questionnaire (CFQ) to assess cognitive function in daily life in 30 formerly eclamptic women, 31 with a history of preeclampsia, and 31 healthy parous women. The groups were matched for age and the year of the index pregnancy, ranging from 1988 to 2005. The CFQ reveals the likelihood of errors in daily tasks that participants should be able to perform. Previously eclamptic women had significantly higher CFQ scores, signifying more cognitive failures, than did healthy women. Eclamptic women who had 3 seizures had significantly higher scores than those having a single seizure, suggesting a cumulative effect. Four of 8 formerly eclamptic women reported being unable to work for health-related reasons, and they received sickness or disability benefits. Although similar numbers of women in all groups had experienced episodes of lack of interest or feeling down, significantly more women with a history of eclampsia or preeclampsia related these episodes specifically to the index pregnancy (or delivery) than did the healthy parous women. Eight formerly eclamptic women—significantly more than in the control group—had received psychological treatment for these problems. Women whose pregnancies are complicated by eclampsia may experience impaired cognitive functioning years afterward. Further research may show whether this reflects permanent damage to cerebral white matter.