BACKGROUND To understand the role of hypertensive disorders of pregnancy (HDP), including preeclampsia and gestational hypertension (GH), in brain health earlier in life, we investigated the association of HDP with midlife cognition and brain health. METHODS We studied a prospective cohort of women, baseline age 18 to 30 years, who were assessed at study years 25 and 30 with a cognitive battery and a subset with brain magnetic resonance imaging. A history of HDP was defined based on self-report. We conducted linear regression to assess the association of a history of preeclampsia, GH, or no HDP with cognition and brain magnetic resonance imaging white matter hyperintensities. RESULTS Among 1441 women (mean age, 55.2±3.6 years), 202 reported preeclampsia and 112 reported GH. GH was associated with worse cognitive performance: global cognition (mean score, 23.2 versus 24.0; P=0.018), processing speed (67.5 versus 71.3; P=0.01), verbal fluency (29.5 versus 31.1; P=0.033), and a trend for executive function (24.3 versus 22.6; P=0.09), after multivariable adjustment. GH was associated with a greater 5-year decline in processing speed (mean change, -4.9 versus -2.7; P=0.049) and executive function (-1.7 versus 0.3; P=0.047); preeclampsia was associated with a greater 5-year decline on delayed verbal memory (-0.3 versus 0.1; P=0.041). GH and preeclampsia were associated with greater white matter hyperintensities in the parietal and frontal lobes, respectively. CONCLUSIONS GH and preeclampsia are associated with cognition and white matter hyperintensities during midlife, with differences in cognitive domains and brain lobes. Women with HDP may need to be closely monitored for adverse brain outcomes starting in midlife.

中文翻译：

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妊娠期高血压疾病和中年大脑健康：CARDIA 研究。


背景为了了解妊娠期高血压疾病（HDP），包括先兆子痫和妊娠高血压（GH）在生命早期大脑健康中的作用，我们研究了HDP与中年认知和大脑健康的关系。方法 我们研究了一组基线年龄为 18 至 30 岁的前瞻性女性，在研究的第 25 年和第 30 年对她们进行了认知电池评估，并用脑磁共振成像对她们进行了评估。 HDP 病史是根据自我报告定义的。我们进行了线性回归来评估先兆子痫、GH 或无 HDP 病史与认知和脑磁共振成像白质高信号的关联。结果 在 1441 名女性（平均年龄 55.2±3.6 岁）中，202 名报告先兆子痫，112 名报告 GH。 GH 与较差的认知表现相关：整体认知（平均得分，23.2 对比 24.0；P=0.018）、处理速度（67.5 对比 71.3；P=0.01）、语言流畅性（29.5 对比 31.1；P=0.033）和趋势多变量调整后的执行功能（24.3 对比 22.6；P=0.09）。 GH 与处理速度（平均变化，-4.9 与 -2.7；P=0.049）和执行功能（-1.7 与 0.3；P=0.047）的 5 年下降幅度更大相关；先兆子痫与言语记忆延迟 5 年下降幅度更大有关（-0.3 与 0.1；P=0.041）。 GH 和先兆子痫分别与顶叶和额叶白质高信号增强相关。结论 GH 和先兆子痫与中年期间的认知和白质高信号相关，且认知区域和脑叶存在差异。患有 HDP 的女性可能需要从中年开始密切监测脑部不良后果。