Impaired Maternal Cognitive Functioning After Pregnancies Complicated by Severe Pre-eclampsia: a Pilot Case-control Study

Background: Pre-eclampsia is the most significant cause of neurological symptoms in pregnancy. Neurological symptoms may persist even after pregnancy. Somatic symptoms of pre-eclampsia, such as hypertension and proteinuria, generally disappear after delivery. However, formerly pre-eclamptic women more often complain of cognitive disturbances compared to women after uncomplicated pregnancies.

Methods: Three to eight months postpartum, a neuropsychological test battery was performed in 10 former severely pre-eclamptic women (according to the guidelines of the American College Obstetricians and Gynecologists) and 10 women after uncomplicated normotensive pregnancies. The control group was matched for age, educational level and mode of anesthesia. All women delivered by cesarean section either under general or regional anesthesia. Tests were performed for premorbid intelligence, short- and long-term memory, attention, concentration, executive functions, visual and spatial abilities. Anxiety and depression levels were measured.

Results: The formerly pre-eclamptic women had significantly lower scores on most indices of the auditory-verbal memory test. Formerly pre-eclamptic patients learned considerably fewer words than controls and recalled less after interference. Both case and control group did not differ in age, parity or level of education. There were no differences in the level of intellectual functioning and language tests, such as naming and word fluency. No persistent differences were observed in tests for attention/concentration and executive functioning. There were no significant differences on depression and anxiety scales.

Conclusions: Maternal memory seems to be impaired after pregnancies complicated by severe pre-eclampsia. This effect cannot be attributed to depression and/or anxiety or method of anesthesia.