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Oral Concurrent Session 5 - Hypertension

Oral Concurrent Sessions

Oral Concurrent Session 5 - Hypertension

(62) Association of Preeclampsia with Long-Term Risk of Neurodegenerative Disorders

Friday, January 31, 2025

2:45 PM – 3:00 PM

Location: Aurora Ballroom B, Lobby Level

Submitting Author and Presenting Author(s)

MB

Maria Bazan, MD, MPH (she/her/hers)

Post doctoral fellow
Beth Israel Deaconess Medical Center
Brighton, Massachusetts, United States

Coauthor(s)

Ai-ris Y. Collier, MD (she/her/hers)

Assistant Professor
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
Tina Yi Hsieh, MD, MPH (she/her/hers)

Researcher
Beth Israel Deaconess Medical Center
Boston, MA, United States
JW

James Cheng-Chung Wei, MD, PhD

Chung-Shan Medical School
Taichung, Taichung, Taiwan (Republic of China)

Objective: Preeclampsia (PE) is a common complication of pregnancy linked to increased lifetime risk of cardiovascular disease. The link between PE and development of adverse neurologic conditions is poorly understood. Our objective was to describe the rates of neurodegenerative disorders occurring 3 or more years following complications from PE compared to those without PE.

Study Design: We utilized the TriNetX database including diagnoses codes from 66 healthcare organizations to identify women 18+ years old with last birth between 1/2000-12/2023. PE was defined using ICD-10 codes occurring before delivery up until December 2020. The comparator group included pregnant women in the same period without PE diagnosis. After 1:1 propensity score matching (PSM) on age at index pregnancy, demographics, health utilization, comorbidities, depression, reproductive factors, and BMI, hazard ratios (HR) and 95% confidence intervals (CI) for cognitive disorders were estimated between the PE and comparator group using a Cox proportional hazard regression model. Cognitive outcomes were identified by ICD-10 codes and censored until one of the following conditions was met: 1) development of an outcome, 2) July 26, 2024, or 3) loss to follow-up in the system.

Results: The cohort included 163,296 pregnant women with PE and 1,647,539 without PE. In those with prior PE, 8,012 (4.9%) developed neurodegenerative outcomes, compared to 46,337(2.8%) in the control group. After PSM, the PE exposure group demonstrated an increased risk of symptomatic cognitive impairment outcomes (HR 1.4, CI 1.351-1.457), Parkinson's disease (HR 1.389, CI 1.035-1.864), Parkinsonism (HR 1.242, CI 1.059-1.455), and combined Parkinson's disease and Parkinsonism (HR 1.285, CI 1.115-1.481) compared to those without PE (Table 1).

Conclusion: Our findings show a higher risk of cognitive impairment, Parkinson's disease, and Parkinsonism in those with a history of PE. Obstetrical health is a window to lifelong neurocognitive health. This study supports enhanced surveillance and monitoring of neurodegenerative diseases.