Pregnancy Hypertension Linked to Increased Risk of Neurological Disorders, finds study
Researchers have established that gestational hypertension, preeclampsia, and eclampsia are associated with a new onset of neurological disorders that occur months to years after delivery. A recent study was conducted by Therese and colleagues which was published in the journal JAMA Neurology.
This cohort of a register-based study performed on first-time mothers from 2005 to 2018 in Sweden found records of 648,385 singleton pregnancies. The study population was from the Swedish Medical Birth Register with follow-up data being sourced from the National Patient Register. Women were followed beginning 42 days post delivery until the first neurological event, death, emigration, or the end of the study period in 2019.
Of the 659,188 primiparous women, there were exclusions of women with chronic hypertension (n=4,271) and pre-existing neurological disorders (n=6,532). Thus, a final cohort of 648,385 women was identified who had a mean age of 28.5 years at the time of their first pregnancy. The main exposures of interest were gestational hypertension, preeclampsia, and eclampsia. The main outcome was a composite of neurological disorders, including migraine, headache, epilepsy, sleep disorders, and mental fatigue. Risk was assessed with Cox regression analysis, expressed as adjusted hazard ratios and 95% confidence intervals.
Key Findings
Prevalence of Conditions
• Gestational hypertension affected 11,133 women.
• Preeclampsia affected 26,797 women.
• Eclampsia was diagnosed in 625 women.
Neurological Risk Increased:
• Women with gestational hypertension had a 27% increased risk of new-onset neurological disorders (aHR, 1.27; 95% CI, 1.12–1.45).
• Preeclampsia was associated with an increased risk of 32% (aHR, 1.32; 95% CI, 1.22–1.42).
• Eclampsia carried the greatest risk with a 70% increase (aHR, 1.70; 95% CI, 1.16–2.50).
Specific Neurological Outcomes:
• Women with eclampsia had a more than fivefold increased risk for epilepsy (aHR, 5.31; 95% CI, 2.85–9.89).
The current findings indicate significant associations between hypertensive pregnancy disorders and new-onset neurological conditions. Routine postpartum visits should include neurological evaluations, particularly for women who experienced gestational hypertension, preeclampsia, or eclampsia. Early detection and management of conditions like epilepsy or mental fatigue could mitigate long-term complications and enhance quality of life. Healthcare providers should prioritize postpartum follow-up for these women, paying special attention to neurological symptoms to ensure timely intervention and improved maternal health outcomes.
Reference:
Friis T, Bergman L, Hesselman S, et al. Gestational Hypertension, Preeclampsia, and Eclampsia and Future Neurological Disorders. JAMA Neurol. Published online December 23, 2024. doi:10.1001/jamaneurol.2024.4426
