Pre-eclampsia poses risk of vascular dementia

Women who experience pre-eclampsia during pregnancy face a heightened risk of vascular dementia later in life, according to the results of a meta-analysis.

Researchers searched multiple online databases for published literature on hypertensive disorders of pregnancy and the subsequent risk for maternal dementia or cognitive impairment. Eligibility criteria were as follows: a population of pregnant women, exposure to a hypertensive disorder of pregnancy of interest, and at least one primary outcome (dementia) or secondary outcome (cognitive impairment). Two reviewers were involved in study selection.

A total of 25 eligible studies, which involved 2,501,673 women, were included in the meta-analysis. Random-effects model was used to calculate the overall pooled estimates, while the adapted version of the validated Newcastle-Ottawa Quality Assessment tool was used to assess bias.

Pooled data showed that pre-eclampsia was associated with an 89-percent increase in the risk of vascular dementia (adjusted hazard ratio [aHR], 1.89, 95 percent confidence interval [CI], 1.47–2.43). No clear associations were observed for Alzheimer’s disease (aHR, 1.27, 95 percent CI, 0.95–1.70) and any (undifferentiated) dementia (aHR, 1.18, 95 percent CI, 0.95–1.47).

However, in an analysis restricted to older women (at least 65 years of age), pre-eclampsia was associated with an elevated risk of Alzheimer’s disease (aHR, 1.92, 95 percent CI, 1.35–2.73) and any dementia (aHR, 1.87, 95 percent CI, 1.21–2.91).