Maternal cognitive functioning after pregnancies complicated by preeclampsia- Analysis of current evidence

Objective: Preeclampsia (PE) is a multi-organ disease affecting 0.5 – 5% of all pregnancies and the most significant cause of neurological symptoms during the peripartum period. Although numerous clinical studies assess neurocognitive outcome of children born to mothers with PE and various animal models of PE dealing with mechanisms and symptoms of this disease exist, there is a lack of basic and clinical research analyzing cognitive performance of mothers after PE. Methods: PubMed search for keywords "Preeclampsia AND cognition/memory", "Preeclampsia AND dementia", "Hypertensive pregnancy AND cognition/memory", "Placental ischemia-induced hypertension AND cognition/memory", "Transgenic preeclampsia rat model AND cognition/memory" and "Reduced uterine perfusion pressure AND cognition/memory" was performed. Publication years 1994 – 2014 were considered for this analysis. Results: Only n = 5 clinical studies were identified dealing with the effect of PE/hypertensive pregnancies on cognitive outcome in mothers, whereas not a single report from basic research was available. Results from clinical research were rather conflicting with n = 2 reporting no effect of a former preeclamptic pregnancy on cognition and n = 3 showing impairments in cognitive functioning later in life. Conclusions: Although neurological symptoms are a well known consequence of pregnancies complicated by PE, basic and clinical studies assessing cognitive abilities in formerly preeclamptic mothers are rare, conflicting or even nonexistent. Given the fact that decrements in cognition and memory can not only lead to psychosocial problems, but could moreover affect the interaction between mother and child, thus tremendously impacting the quality of life of both, more research relating to the origin and management of these issues is highly required.