Gestational hypertension, preeclampsia, and eclampsia increases risk of neurologic conditions, suggests study

A new study published in the Journal of American Medical Association found that in the years after a first pregnancy, there is a markedly increased risk for neurologic conditions like migraine or epilepsy in the mothers with gestational hypertension, preeclampsia, or eclampsia.

It is unknown if the pregnancy issues (preeclampsia, prenatal hypertension, and eclampsia) are linked to a higher chance of developing neurological diseases months or years after giving birth. Therefore, Therese Friis and her colleagues carried out this study to investigate if new-onset headache, migraine, sleep problem, epilepsy, or mental weariness within months to years after giving birth are linked to gestational hypertension, preeclampsia, and eclampsia.

A total of 659,188 primiparous women with singleton pregnancies between 2005 and 2018 were identified through the Swedish Medical Birth Register. The women with a screening of chronic hypertension or a prepregnancy neurological disorder were excluded and the final study population included 648 385 women with the data analyses in 2023.

This register-based cohort study identified exposures in the Swedish Medical Birth Register from 2005 to 2018 and followed up using the National Patient Register, which included diagnoses from specialized inpatient and outpatient care for 42 days after delivery until the first event, emigration, death, or the end of the follow-up period. A composite neurological consequence of headache, migraine, epilepsy, sleep problem, or mental exhaustion was the main result.

The mean age of the 648,385 women in the research at the time of their first pregnancy was 28.5 (SD, 5.0). When compared to women with normotensive pregnancies, women with gestational hypertension (n = 11133), preeclampsia (n = 26797), and eclampsia (n = 625) were significantly more likely to have a new-onset neurological condition.

For pregnant hypertension, the aHR was 1.27; for preeclampsia, it was 1.32; and for eclampsia, it was 1.70. Women with eclampsia were linked to a risk of epilepsy that was more than five times higher when looking at individual outcomes.

Overall, given their elevated risk of cardiovascular disease, guidelines advise women with gestational hypertension and preeclampsia to have follow-up care after giving birth. As this group of women seem to be at risk for neurological problems, caregivers should also be aware of any new or persistent neurological symptoms during these visits.

Source:

Friis, T., Bergman, L., Hesselman, S., Lindström, L., Junus, K., Cluver, C., Escudero, C., & Wikström, A.-K. (2024). Gestational Hypertension, Preeclampsia, and Eclampsia and Future Neurological Disorders. In JAMA Neurology. American Medical Association (AMA). https://doi.org/10.1001/jamaneurol.2024.4426