Elharram M, et al. - Studies investigating an association between a history of preeclampsia and cognitive function later in life were systematically reviewed and summarized. Findings suggested an association of preeclampsia with subjective cognitive symptoms, but, there appeared no clear evidence of impairment on standard neurocognitive tests. High-quality studies assessing cognitive outcomes after preeclampsia were scarce.

Methods

• Researchers performed electronic searches of 10 main databases including MEDLINE and ClinicalTrials.gov to assess studies published before August 2017 without any language restriction or study design limits.
• Consideration for inclusion was given to all observational studies that included preeclampsia as a clearly defined prespecified risk factor and that examined a cognition-related outcome measure including validated cognitive tests, magnetic resonance brain imaging, or a clinical diagnosis of dementia.
• The New-Castle Ottawa scale was used to assess the quality of the studies.
• Two reviewers independently conducted all review stages, and disagreement between them was resolved by a third reviewer.
• Where possible, a random-effects model was used to pool data.

Results

• Researchers identified 3,126 potentially relevant studies.
• Of these, they included 13 in this review (1,314 women with prior preeclampsia and 289,080 women with prior normotensive pregnancy); median time since pregnancy was 6 years.
• Women with prior preeclamptic pregnancies reported a higher number of self-reported deficits in perception, memory, and motor functioning on the Cognitive Failure Questionnaire compared to women without prior preeclamptic pregnancies (Cognitive Failure Questionnaire mean total score 41.5 vs 36.8 out of 100, weighted mean difference of -5.1 points [-9.4 to -0.8]).
• As per this meta-analysis, studies assessing attention were not significantly different (Digit Symbol Substitution or Coding); however, worse performance of women with preeclampsia was noted on one of two meta-analyzed tests assessing memory (Letter Number Sequencing mean total score: 10.6 vs 10.1 out of 21, weighted mean difference of 0.63 points 0.06–1.2).
• As the studies assessing brain imaging or clinical diagnosis of dementia differed in reporting and had marked heterogeneity, pooling of cognitive outcome measures were limited.