title: The brain study: Cognition, quality of life and social functioning following preeclampsia; An observational study.
abstract: OBJECTIVE
  Previously preeclamptic women may express cognitive difficulties, which have largely been unappreciated or attributed to stresses of a complicated pregnancy. This study aimed to explore the scope of perceived neurocognitive and psychosocial problems as well as quality of life following preeclampsia.
  
  
  METHODS
  Observational study. Through website promotion and e-mail, registrants of the USA-based Preeclampsia Foundation who experienced preeclampsia in the past 20years were invited to complete a web-based survey. Participants were requested to ask an acquaintance that had a normotensive pregnancy to also complete the survey (controls).
  
  
  METHODS
  The Cognitive Failures Questionnaire (CFQ), abbreviated WHO Quality Of Life questionnaire (WHOQOL-BREF), Social Functioning Questionnaire (SFQ) and Breslau Short Screening Scale for DSM-IV Posttraumatic Stress Disorder were used in the survey. Analysis was performed using Mann-Whitney U tests and linear regression.
  
  
  RESULTS
  966 cases and 342 controls completed the survey (median age 34, median time since first pregnancy 4 vs. 5years). Cases scored significantly worse on CFQ (median 35 vs. 27), WHOQOL-BREF domains physical health (15 vs. 17), psychological (13 vs. 15), social relationships (13 vs. 15) and environment (15 vs. 16), and SFQ (8 vs. 7). All p<0.001. Multivariable analysis showed an independent significant effect of eclampsia on CFQ and of migraine on all questionnaires and the effect of preeclampsia was still present after adjustment for confounders. Posttraumatic stress symptoms accounted for part of the relationships.
  
  
  CONCLUSIONS
  Previously preeclamptic women appear to perceive more cognitive and social problems, and report poorer quality of life compared to a group of women with normotensive pregnancies. Research relating to the origin and management of these issues is needed.
authors.affiliation: Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, The Netherlands. Electronic address: i.r.postma@umcg.nl.
authors.forename: I R
authors.initials: IR
authors.lastname: Postma
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Groen
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, University of Washington, Seattle, WA, USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Easterling
authors.affiliation: Preeclampsia Foundation, Melbourne, FL, USA.
authors.forename: E Z
authors.initials: EZ
authors.lastname: Tsigas
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Wilson
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Porcel
authors.affiliation: Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus Medical Center Rotterdam, The Netherlands.
authors.forename: G G
authors.initials: GG
authors.lastname: Zeeman
keywords: Cognitive functioning; Eclampsia; Long-term consequences; Preeclampsia