Postma Ineke Rixt, Bouma Anke, Ankersmit Iefke Froukje, Zeeman Gerda Geertruida
Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands.
Am J Obstet Gynecol. 2014 Jul;211(1):37.e1-9. doi: 10.1016/j.ajog.2014.01.042. Epub 2014 Feb 1.
Women who suffered preeclampsia and eclampsia may report subjective cognitive difficulties in daily life, the interpretation of which is cumbersome, because these are affected by emotional factors. Previous studies only included preeclamptic women investigated shortly after pregnancy. We aimed to determine whether these subjective reports of cognitive difficulty could be interpreted as reflecting objective cognitive dysfunction. Therefore, cognitive functioning was assessed using standardized neurocognitive tests in both preeclamptic and eclamptic women several years following the index pregnancy.
Forty-six formerly eclamptic, 51 formerly preeclamptic, and 48 control women who had normotensive pregnancies, age-matched, participated in this study. Average elapsed time since index pregnancy was 7 years. Neurocognitive tests were divided into 6 domains; visual perception, motor functions, working memory, long-term memory, attention, and executive functioning. Subjective cognitive functioning was measured by the Cognitive Failures Questionnaire and anxiety/depression by the Hospital Anxiety and Depression Scale.
Both preeclamptic and eclamptic women performed worse on the motor functions domain (P < .05), without differences on the other domains. They scored worse on the Cognitive Failures Questionnaire (P < .01), the Hospital Anxiety and Depression Scale anxiety (P < .01), and depression (P < .05) subscales.
Women who suffered eclampsia and/or preeclampsia demonstrate no objective cognitive impairment as compared with controls. Contrary to the well-structured test setting, both groups do report more cognitive failures, which are thought to reflect neurocognitive dysfunction in complex, stressful daily-life situations. Such report of cognitive failures may be compounded by anxiety and depression. Future studies should focus on the relationship of neurocognitive functioning with structural cerebral abnormalities.
患有先兆子痫和子痫的女性可能会报告日常生活中存在主观认知困难，但其解读较为复杂，因为这些会受到情绪因素的影响。以往研究仅纳入了孕期后不久接受调查的先兆子痫女性。我们旨在确定这些关于认知困难的主观报告是否可被解读为反映了客观认知功能障碍。因此，在本次妊娠指数后的数年里，我们使用标准化神经认知测试对先兆子痫和子痫女性的认知功能进行了评估。
46名曾患子痫、51名曾患先兆子痫以及48名妊娠血压正常且年龄匹配的对照女性参与了本研究。自妊娠指数以来的平均时间为7年。神经认知测试分为6个领域：视觉感知、运动功能、工作记忆、长期记忆、注意力和执行功能。主观认知功能通过认知失误问卷进行测量，焦虑/抑郁通过医院焦虑抑郁量表进行测量。
先兆子痫和子痫女性在运动功能领域的表现均较差（P < .05），在其他领域则无差异。她们在认知失误问卷（P < .01）、医院焦虑抑郁量表焦虑（P < .01）和抑郁（P < .05）分量表上的得分更低。
与对照组相比，患有子痫和/或先兆子痫的女性未表现出客观认知损害。与结构完善的测试环境相反，两组均报告了更多的认知失误，这被认为反映了复杂、压力大的日常生活情境中的神经认知功能障碍。这种认知失误的报告可能因焦虑和抑郁而加剧。未来的研究应聚焦于神经认知功能与脑结构异常之间的关系。
