Preeclampsia and cognitive impairment later in life.
Preeclampsia and cognitive impairment later in life.
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DOI：
10.1016/j.ajog.2017.03.008
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发表时间：
2017-07
影响因子：
9.8
通讯作者：
Miller VM
中科院分区：
文献类型：
--
作者：
Fields JA;Garovic VD;Mielke MM;Kantarci K;Jayachandran M;White WM;Butts AM;Graff-Radford J;Lahr BD;Bailey KR;Miller VM
高血压是脑血管疾病和认知障碍的危险因素。在怀孕期间遭受高血压发作的妇女报告在受影响的怀孕后的第一个十年内发生了不同的神经认知变化。然而，还没有对这些妇女进行绝经后的长期随访。这项研究的目的是检查有先兆子痫病史的妇女在受影响的怀孕35-40年后是否有认知能力下降的风险增加。妇女是通过医学联系、基于人口的罗切斯特流行病学项目来确定和招募的。40名有先兆子痫病史的女性与40名有正常血压孕产史的女性年龄和产次相匹配。所有女性都接受了全面的神经心理评估，并完成了测量情绪的自我报告问卷，即抑郁、焦虑和其他与情绪状态有关的症状。比较两组间的得分。此外，神经心理学家和一名对怀孕状态视而不见的神经科医生检查了个体认知分数，并对每个参与者的正常、轻度认知障碍或痴呆症做出了临床共识诊断。在子痫前期组(59.2岁，50.9-71.5岁)和正常血压组(59.6岁，52.1-72.2岁)之间，同意时的年龄没有差异，指数妊娠时间也没有差异(分别为34.9岁，32.0-47.2岁和34.5岁，范围32.0-46.4)。有先兆子痫病史的女性与有正常妊娠史的女性在认知和情绪测试上的原始分数没有统计学差异。然而，在有先兆子痫病史的妇女中，轻度认知障碍或痴呆的普遍诊断倾向于比有正常血压妊娠史的妇女更频繁(20%对8%，p=0.10)，并且在先兆子痫组中受影响的领域更多(p=0.03)，最与执行功能障碍(d=1.96)和语言学习障碍(d=1.93)密切相关。这些发现表明，有先兆子痫病史的女性在晚年生活中表现出的认知障碍比有正常血压怀孕史的女性更多。此外，认知改变的模式与血管疾病/白质病理学观察到的一致。
Hypertension is a risk factor for cerebrovascular disease and cognitive impairment. Women who suffer hypertensive episodes during pregnancy report variable neurocognitive changes within the first decade following the affected pregnancy. However, long-term follow-up of these women into their post-menopausal years has not been conducted. The aim of this study was to examine whether women with a history of preeclampsia were at increased risk of cognitive decline 35–40 years after the affected pregnancy. Women were identified and recruited through the medical linkage, population-based Rochester Epidemiologic Project. Forty women with a history of preeclampsia were age- and parity-matched to 40 women with a history of normotensive pregnancy. All women underwent comprehensive neuropsychological assessment and completed self-report inventories measuring mood, i.e., depression, anxiety, and other symptoms related to emotional state. Scores were compared between groups. In addition, individual cognitive scores were examined by neuropsychologists and a neurologist blinded to pregnancy status, and a clinical consensus diagnosis of normal, mild cognitive impairment, or dementia for each participant was conferred. Age at time of consent did not differ between preeclampsia (59.2 years, range 50.9–71.5) and normotensive (59.6 years, range 52.1–72.2) groups, nor did time from index pregnancy (34.9 years, range 32.0–47.2 vs 34.5 years, range 32.0–46.4, respectively).There were no statistically significant differences in raw scores on tests of cognition and mood between women with histories of preeclampsia compared to women with histories of normotensive pregnancy. However, a consensus diagnosis of mild cognitive impairment or dementia trended towards greater frequency in women with histories of preeclampsia compared to those with normotensive pregnancies (20% versus 8%, p = 0.10) and affected more domains among the preeclampsia group (p = 0.03), most strongly related to executive dysfunction (d = 1.96) and verbal list learning impairment (d = 1.93). These findings suggest a trend for women with a history of preeclampsia to exhibit more cognitive impairment later in life than those with a history of normotensive pregnancy. Furthermore, the pattern of cognitive changes is consistent with that observed with vascular disease/white matter pathology.
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DOI：
10.1111/1471-0528.13057
发表时间：
2015-07-01
影响因子：
5.8
作者：
Breetveld, N. M.;Ghossein-Doha, C.;Spaanderman, M. E. A.
通讯作者：
Spaanderman, M. E. A.
影响因子：
9.9
作者：
Cournot, M.;Marquie, J. -C.;Ruidavets, J. -B.
通讯作者：
Ruidavets, J. -B.
DOI：
10.3233/jad-2010-091555
发表时间：
2010
期刊：
Journal of Alzheimer's disease : JAD
影响因子：
--
作者：
Knopman DS;Roberts R
通讯作者：
Roberts R
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
DOI：
10.1080/01674820802546212
发表时间：
2009-01-01
影响因子：
3.1
作者：
Baecke, Martina;Spaanderman, Mark E. A.;van der Werf, Sieberen P.
通讯作者：
van der Werf, Sieberen P.