Are brain structure differences linked to a history of preeclampsia years after pregnancy?

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The study aimed to determine whether brain structure changes after preeclampsia might help explain these women's increased cerebrovascular risk. Researchers conducted a case-control study of women 5–15 years after a pregnancy with preeclampsia or a normotensive pregnancy. They performed brain MRI. To assess white matter lesion volume, they used voxel-based segmentation of fluid-attenuation inversion recovery sequences; they used diffusion tensor imaging to measure microstructural integrity. Gray matter volumes were analyzed using a voxel-based approach adjusted for skull size.

The study included 34 women with previous preeclampsia, aged 42.8 ± 5.1 years, and 49 controls. The previously preeclamptic group had lower cortical gray matter volume than controls (523.2 ± 30.1 vs 544.4 ± 44.7 mL, p < 0.05); both groups had white matter lesions, but changes were more extensive in the previously preeclamptic group. Temporal lobe white matter lesion volume was greater in the previously preeclamptic group (23.2 ± 24.9 vs 10.9 ± 15.0 μL, p < 0.05), and microstructural integrity was altered (radial diffusivity: 538 ± 19 vs 526 ± 18 × 10−6 mm²/s, p < 0.01); the microstructural changes also extended to the occipital and parietal lobes. In women with previous preeclampsia, the degree of temporal lobe white matter change was independent of their current cardiovascular risk profile (p < 0.05) and increased with time since the index pregnancy (p < 0.05).

The authors concluded that a history of preeclampsia is associated with temporal lobe white matter changes and reduced cortical volume in young women, out of proportion to their classic cardiovascular risk profile. The severity of changes was proportional to time since pregnancy, consistent with continued accumulation of damage after pregnancy.