Patients with a history of preeclampsia are at increased risk for young onset dementia, according to study results published in JAMA Network Open.
Previous research has demonstrated that individuals who experience preeclampsia during pregnancy are at increased risk for cardiovascular and kidney morbidity and mortality. However, relatively little is known about the relationship between preeclampsia and dementia incidence.
To this aim, investigators from Santé Publique France and Université Paris Cité in France conducted a study to evaluate the association between preeclampsia and other hypertensive disorders of pregnancy (HDPs) and the risk for young onset dementia. The investigators used data for this analysis from the Conception study, which was a nationwide prospective cohort study that sourced data from the French National Health Insurance Information System. Women (N=1,966,323) aged 30 years and older who delivered a baby after 22 weeks gestation between 2010 and 2018 were followed through 2021 for incident dementia. Early preeclampsia was defined as a diagnosis before 34 weeks gestation.
Of the almost 2 million women included in the analysis, a total of 128 women were diagnosed with dementia during follow-up. The women diagnosed with dementia had a mean (SD) age of 36.4 (4.1) years, 3.1% were obese, 5.5% had chronic hypertension prior to pregnancy, 8.6% had gestational hypertension, and 7.0% had preeclampsia. The cohort without dementia had a mean (SD) age of 34.6 (3.3) years, 4.4% were obese, 2.5% had chronic hypertension before pregnancy, 5.9% had gestational hypertension, and 2.9% had preeclampsia.
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The results add early-onset preeclampsia to the list of lifelong disease risks or health care implications of having had preeclampsia.
Among dementia cases, the risk for young onset dementia was significantly higher among patients with a history of preeclampsia (adjusted hazard ratio [aHR], 2.65; 95% CI, 1.34-5.22) but not gestational hypertension (aHR, 1.46; 95% CI, 0.78-2.71), relative to women who had no HDPs.
When stratified by preeclampsia type, young onset dementia was associated with preeclampsia superimposed on chronic hypertension (aHR, 4.76; 95% CI, 1.49-15.22) and early preeclampsia (aHR, 4.15; 95% CI, 1.30-13.14), but not severe preeclampsia (aHR, 1.45; 95% CI, 0.36-5.88) compared with women who had no HDPs.
“More studies are needed to confirm these initial findings and to ascertain whether preeclampsia is an independent risk factor for dementia and whether preeclampsia and young-onset dementia share common risk factors or a physiological susceptibility to dementia unmasked by pregnancy,” the investigators concluded. “The results add early-onset preeclampsia to the list of lifelong disease risks or health care implications of having had preeclampsia.”
This study was limited by the small sample size of the young onset dementia group and the reliance on hospital diagnosis of young onset dementia, which may have led to an underestimated prevalence.
Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.