Neurocognitive functioning following preeclampsia and eclampsia: a long-term follow-up study.
OBJECTIVE
Women who suffered preeclampsia and eclampsia may report subjective cognitive difficulties in daily life, the interpretation of which is cumbersome, because these are affected by emotional factors. Previous studies only included preeclamptic women investigated shortly after pregnancy. We aimed to determine whether these subjective reports of cognitive difficulty could be interpreted as reflecting objective cognitive dysfunction. Therefore, cognitive functioning was assessed using standardized neurocognitive tests in both preeclamptic and eclamptic women several years following the index pregnancy.


METHODS
Forty-six formerly eclamptic, 51 formerly preeclamptic, and 48 control women who had normotensive pregnancies, age-matched, participated in this study. Average elapsed time since index pregnancy was 7 years. Neurocognitive tests were divided into 6 domains; visual perception, motor functions, working memory, long-term memory, attention, and executive functioning. Subjective cognitive functioning was measured by the Cognitive Failures Questionnaire and anxiety/depression by the Hospital Anxiety and Depression Scale.


RESULTS
Both preeclamptic and eclamptic women performed worse on the motor functions domain (P < .05), without differences on the other domains. They scored worse on the Cognitive Failures Questionnaire (P < .01), the Hospital Anxiety and Depression Scale anxiety (P < .01), and depression (P < .05) subscales.


CONCLUSIONS
Women who suffered eclampsia and/or preeclampsia demonstrate no objective cognitive impairment as compared with controls. Contrary to the well-structured test setting, both groups do report more cognitive failures, which are thought to reflect neurocognitive dysfunction in complex, stressful daily-life situations. Such report of cognitive failures may be compounded by anxiety and depression. Future studies should focus on the relationship of neurocognitive functioning with structural cerebral abnormalities.
Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Ineke Rixt
IR
Postma
Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.
Anke
A
Bouma
Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.
Iefke Froukje
IF
Ankersmit
Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Gerda Geertruida
GG
Zeeman
D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D004461:Eclampsia / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011225:Pre-Eclampsia / Q000503:physiopathology / Q000523:psychology*; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D011596:Psychomotor Disorders / Q000209:etiology; D057566:Self Report; D011795:Surveys and Questionnaires
anxiety and depression; cognitive complaints; eclampsia; neurocognitive functioning; preeclampsia