Cognitive and Neuropsychiatric Sequelae in Postpartum Women with Preeclampsia: A Prospective Cohort Study

Abstract

Objective:  This study aimed to prospectively evaluate cognitive function and neuropsychiatric outcomes in postpartum women with a history of preeclampsia compared to normotensive controls. It further sought to identify key predictors of cognitive impairment and mood disturbances within this high-risk group.

Materials and Methods:  Between January and December 2024, a forward-looking cohort investigation was implemented at a tertiary healthcare institution. A total of 280 postpartum participants were included, comprising 160 women diagnosed with preeclampsia and 120 normotensive counterparts, with both groups balanced in terms of age and parity. Cognitive performance was measured using the Montreal Cognitive Assessment (MoCA), while emotional health was monitored through the Hospital Anxiety and Depression Scale (HADS) and the Edinburgh Postnatal Depression Scale (EPDS) during follow-up visits conducted at 6 and 12 months after childbirth.

Results:  At 12 months postpartum, women in the preeclampsia group exhibited significantly lower mean MoCA scores (23.6 vs. 26.1, p<0.001) and a higher prevalence of clinically significant anxiety (38.1% vs. 15.8%) and depression (29.4% vs. 10.8%) than controls. Logistic regression identified severe preeclampsia, low educational status, and elevated EPDS scores as independent predictors of cognitive impairment.

Conclusion:  Women with a history of preeclampsia are at increased risk for cognitive and psychiatric sequelae in the postpartum period. These findings underscore the importance of structured neuropsychiatric screening and early intervention in postpartum care for this high-risk population.