Cerebral volume is unaffected after pre-eclampsia

OBJECTIVE: Pre-eclampsia, a hypertensive complication of pregnancy, has been associated with cardiovascular, cerebrovascular, and/or psychological complaints. Signs of an altered brain morphology and more white matter hyperintensities during and shortly after preeclampsia were observed in some, but not all, earlier studies. Here, cerebral volumes, the number of white matter hyperintensities and the age-related effects were compared in formerly pre-eclamptic women and women with normotensive gestational history.

METHODS: Structural 7-Tesla magnetic resonance images of the cerebrum were acquired of 59 formerly pre-eclamptic women (aged 37±6 years, 0.5-16 years postpartum) and 20 women with normotensive pregnancies (aged 39±5 years, 1-18 years postpartum). Fazekas scores were obtained to assess white matter hyperintensity load. Volumes of the whole brain, gray and white matter, brain lobes, ventricular cerebrospinal fluid (CSF), and pericortical CSF were calculated after semi-automatic segmentation. Group differences were analyzed with ANCOVA and Bayes factors. Results were adjusted for age, educational attainment and total intracranial volume. Effects of age on cerebral volumes was analyzed using a linear regression analysis.

RESULTS: No changes in global and local brain volumes were observed between formerly pre-eclamptic and control women. Also, no difference in white matter hyperintensity load was observed. Independent of pre-eclamptic history, gray matter volume significantly decreased with age, while ventricular and peri-cortical CSF volumes significantly increased with age.

CONCLUSIONS: Volumetric changes of the cerebrum are age-related, but independent of a pre-eclamptic history in the first two decades after childbirth. No evidence for more white matter lesions after pre-eclampsia was found. This article is protected by copyright. All rights reserved.