Hypertensive Pregnancies Linked to Increased Risk of Neurologic Conditions

A Swedish register-based cohort study, published in JAMA Neurology, has found that women who experience gestational hypertension, preeclampsia, or eclampsia during pregnancy face an elevated risk of developing neurologic disorders in the months to years following childbirth, including migraine, headache, epilepsy, sleep disorder, and mental fatigue.

Researchers analyzed data from 648,385 primiparous women (mean age, 28.5 years) without a history of chronic hypertension or neurologic disorders who gave birth between 2005 and 2018. Cox regression analysis was used to calculate adjusted hazard ratios (aHR) for a composite neurologic outcome of the 5 diagnoses between 42 days and 15 years after delivery.

The results showed increased risks for the composite outcome in women with gestational hypertension (aHR 1.27; 95% CI, 1.12 to 1.45), preeclampsia (aHR 1.32; 95% CI, 1.22 to 1.42), and eclampsia (aHR 1.70; 95% CI, 1.16 to 2.50) compared to those with normotensive pregnancies. Notably, researchers found that women with eclampsia had a more than 5-fold increased risk of developing epilepsy (aHR 5.31; 95% CI, 2.85 to 9.89) when they examined individual diagnoses.

These findings suggest that special attention should be paid to persistent or new-onset neurologic symptoms in women who experienced hypertensive disorders during pregnancy. They also contribute an important understanding of the short- to medium-term neurologic effects of these disorders, adding to research that shows an established association between these disorders and stroke and vascular dementia in the long term.