Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of cardiovascular disorders, with recent evidence linking pre-eclampsia with vascular dementia. We examined associations of HDP with cognitive performance measured in midlife, in a prospective cohort study, the Avon Longitudinal Study of Parents and Children. Six cognitive function domains were measured 20 years after pregnancy at a mean age of 51 years. The cognition tests were repeated at clinics in the following two years. Cognitive function domains measured were immediate and delayed verbal episodic memory, working memory, processing speed, verbal intelligence, and verbal fluency. Exposures were pre-eclampsia, gestational hypertension (GH), and a combined category of any HDP, all compared to normotensive pregnancy. Of 3393 pregnancies included in the analysis, GH was experienced by 417 (12.3%) and pre-eclampsia by 57 (1.7%). GH was associated with lower verbal episodic memory, in the delayed logic memory test (-0.16 SDs; 95% CI -0.30, -0.03; p = .015) and there was weak evidence of an association with the immediate logic memory test (-0.13 SDs; -0.27, 0.001; p = .058). However, we did not see steeper declines by age for women with GH and there was no evidence of associations with other cognitive domains or for pre-eclampsia with any domains. Results were not substantially changed after controlling for midlife blood pressure. Our findings suggest that a history of GH is associated with slightly reduced episodic memory 20 years after pregnancy, but we found no evidence of a quicker age-related decline compared to women with normotensive pregnancies.

中文翻译：

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一项前瞻性队列研究中妊娠期高血压疾病和中年母亲认知

妊娠期高血压疾病 (HDP) 与心血管疾病风险增加相关，最近的证据表明先兆子痫与血管性痴呆有关。我们在一项前瞻性队列研究（雅芳父母和儿童纵向研究）中研究了 HDP 与中年认知表现的关联。怀孕 20 年后，平均年龄为 51 岁，对六个认知功能领域进行了测量。接下来的两年里，认知测试在诊所重复进行。测量的认知功能领域包括即时和延迟言语情景记忆、工作记忆、处理速度、言语智力和言语流畅性。暴露对象为先兆子痫、妊娠期高血压 (GH) 以及任何 HDP 的综合类别，所有这些均与血压正常妊娠进行比较。在分析中纳入的 3393 例妊娠中，有 417 例 (12.3%) 患有生长激素，57 例 (1.7%) 患有先兆子痫。在延迟逻辑记忆测试中，GH 与较低的言语情景记忆相关（-0.16 SD；95% CI -0.30，-0.03；p  = .015），并且有微弱的证据表明与即时逻辑记忆测试相关（- 0.13 标准差；-0.27，0.001；p  = .058）。然而，我们没有看到患有 GH 的女性随着年龄的增长而急剧下降，也没有证据表明与其他认知领域或先兆子痫与任何领域相关。控制中年血压后，结果没有显着变化。我们的研究结果表明，GH 病史与怀孕 20 年后情景记忆略有下降有关，但我们没有发现与血压正常妊娠的女性相比，与年龄相关的下降更快的证据。