P.016 Hypertensive disorders in pregnancy are associated with future development of vascular dementia: A systematic review and meta-analysis

Abstract

Background: We aimed to evaluate the association between hypertensive disorders in pregnancy (HDP) and future risk of cognitive impairment and dementia. Methods: Systematic searches were performed in MEDLINE and EMBASE up to April 27^th, 2020. Exposure of interest included the different types of HDP. Outcomes of interest included dementia incidence, dementia subtype, and cognitive testing. Results: On qualitative review, 4/9 studies showed impaired memory, visual motor processing speed, executive function, and verbal testing in previously preeclamptic women. 2/4 studies showed impaired visual motor processing and subjective cognitive complaints in previously eclamptic women. Six cohort studies involving >2.6 million women were included in the meta-analysis. Pooled hazard ratios (aHR) with 95% confidence intervals were generally adjusted for age at delivery ethnicity, and vascular risk factors. Women with a history of gestational hypertension were more likely to develop vascular dementia (aHR 2.02 [1.45-2.83],I²:0%), but not Alzheimer disease (1.24 [0.93-1.66],single-study). Women with a history of preeclampsia were also more likely to develop vascular dementia (2.17 [1.20-3.91],I²:61.1%), but not Alzheimer dementia (1.19 [0.83-1.69],I²:69.9%). Conclusions: Whereas studies of neuropsychological testing in previously preeclamptic and eclamptic women have been heterogeneous, a history of HDP is associated with developing vascular dementia in later life.