Cognitive impairment in pre-eclampsia complicated by eclampsia and
pulmonary oedema after delivery: a case control study
Abstract
Objectives We aimed to assess cognitive function in women with
pre-eclampsia stratified by severity, before and after onset of disease.
Design Prospective case control study Setting Single center study at a
referral hospital in Cape Town, South Africa. Population Pregnant women
between 20 and 42 weeks gestation with eclampsia, pulmonary oedema,
pre-eclampsia without severe features a normotensive pregnancy. Methods
Women were included at diagnosis (cases) or at admission for delivery
(controls). Two cognitive assessments, the Cognitive Failure
Questionnaire (CFQ) to assess the cognitive function subjectively before
inclusion in the study, and Montreal Cognitive Assessment (MoCA) to
assess the current cognitive function objectively before discharge from
the hospital after delivery were performed. Main outcome measures Total-
and subscores from the CFQ and MoCa tests. Results We included 61 women
with eclampsia, 28 with pre-eclampsia complicated by pulmonary oedema,
38 with pre-eclampsia without severe features and 26 with normotensive
pregnancies. There was no difference in cognitive function from early
pregnancy between groups. Women with eclampsia and pre-eclampsia
complicated by pulmonary oedema scored lower on the MoCA assessment at
time of discharge compared to women with normotensive pregnancies. The
results were attenuated in pulmonary oedema after adjustment for
confounders. Conclusion Women with pre-eclampsia complicated by
pulmonary oedema and in particular eclampsia had impaired cognitive
function after onset of disease compared to normotensive pregnant
controls. The impairment did not seem to be present before onset of
disease. Women with pre-eclampsia without severe features did not have
impaired cognitive function.