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January/February 2025
Birth and pregnancy complications may be linked to risk of neurological disorders
By Melanie Hinze
Research published in JAMA Neurology reports an increased risk of new-onset neurological disorders in the months or years following a pregnancy complicated by gestational hypertension, pre-eclampsia or eclampsia.
The cohort study included 648,385 primiparous women with a mean age of 28.5 years at their first pregnancy from the Swedish Medical Birth Register between 2005 to 2018. Follow up began 42 days after delivery and continued until the first event, death, emigration or the end of the follow-up period in 2019.
Women with gestational hypertension, pre-eclampsia and eclampsia had an increased risk for a new-onset neurological disorder, including migraine, headache, epilepsy, sleep disorder, or mental fatigue, when compared with women with normotensive pregnancies. The strongest association was seen in women with eclampsia, who had a more than five times increased risk of epilepsy.
Associate Professor Cheryl Carcel, Neurologist and Head of the Brain Health Program at The George Institute for Global Health, Sydney, and Conjoint Associate Professor at UNSW Sydney, said, ‘These findings remind us that in people with adverse outcomes of pregnancy, such as gestational hypertension, pre-eclampsia and eclampsia, the postpartum period is an opportunity to optimise not only cardiovascular, but also brain health.’
Associate Professor Carcel said that primary care has a key role in the transition of care from the postpartum period.
‘As such, GPs can use data from this study and others like it in their discussions with patients,’ she said.
In this way, patients can be educated on the fact that adverse pregnancy outcomes can increase the risk of future cardiovascular disease and neurological disorders.
‘Regarding this study, the relationship between eclampsia and future epilepsy is quite strong,’ she said.
‘For future research it would be helpful to understand when epilepsy occurred postpartum (early or late), the mechanism underlying the relationship, and whether this is idiopathic epilepsy or due to secondary causes (such as intracerebral haemorrhage from elevated blood pressure),’ she added.