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Cerebral white matter lesions after pre-eclampsia.

P Soma-Pillay1, F E Suleman2, J D Makin1

  • 1Department of Obstetrics and Gynaecology, University of Pretoria and Steve Biko Academic Hospital, South Africa; South African Medical Research Council Maternal and Infant Health Care Strategies Unit, South Africa.

Pregnancy Hypertension
|May 15, 2017
PubMed
Summary

Women with severe pre-eclampsia may develop cerebral white matter lesions, particularly those needing multiple blood pressure medications during pregnancy. These lesions persist postpartum, indicating potential long-term neurological risks.

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Area of Science:

  • Neurology
  • Obstetrics
  • Radiology

Background:

  • Previous pre-eclampsia is linked to higher rates of cerebral white matter lesions years later.
  • The exact cause and timing of these lesions remain unclear.
  • White matter lesions increase risks for stroke, dementia, and mortality in the general population.

Purpose of the Study:

  • To assess the prevalence of cerebral white matter lesions in women with severe pre-eclampsia at delivery, 6 months, and 1 year postpartum.
  • To investigate the underlying pathophysiology and identify risk factors for these lesions.

Main Methods:

  • A longitudinal study involving 94 women with severe pre-eclampsia at Steve Biko Academic Hospital, Pretoria, South Africa.
  • Brain Magnetic Resonance Imaging (MRI) was conducted postpartum, at 6 months, and at 1 year.

Main Results:

  • Cerebral white matter lesions were present in 61.7% at delivery, decreasing to 47.9% at 1 year postpartum.
  • Lesions were predominantly in the frontal lobes.
  • Lesion presence at 1 year correlated with the number of antihypertensive drugs used during pregnancy (OR 5.1) and was double in women with chronic hypertension.

Conclusions:

  • Women requiring multiple antihypertensive medications during pregnancy face a higher risk of postpartum cerebral white matter lesions.
  • These findings highlight potential long-term neurological implications of severe pre-eclampsia.