Adverse Pregnancy Outcomes and Cognitive Change in Older Women

Whether the history of adverse pregnancy outcomes (APOs) contributes to cognitive decline in women is unclear.

Among parous female Adult Changes in Thought (ACT) participants (aged ≥ 65 years without dementia at enrollment), we abstracted APO history for those born 1940 or later and enrolled between 2005 and 2020 (n = 444). Generalized estimating equations estimated the association between APO history and cognition score, measured using the Cognitive Abilities Screening Instrument assessment using item response theory (CASI-IRT), and cognitive decline.

Among all participants, 13% had a history of APO. In adjusted models, women with an APO history had 0.23-point lower CASI-IRT score at any age (95% confidence interval: -0.54, 0.07); this small difference was not statistically significant. We found no evidence of an association between APO history and 4-year cognitive change.

Among women in the ACT study born in 1940 or later, we found no evidence of a significant association between history of APO and lower cognition or cognitive decline in older adulthood.