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Abstract Details

Associations of Adverse Pregnancy Outcomes with Cognitive Impairment and Dementia: A Systematic Review and Meta-analysis
Aging, Dementia, and Behavioral Neurology
P2 - Poster Session 2 (8:00 AM-9:00 AM)
3-005
We aimed to systematically review the literature examining the associations of Adverse Pregnancy outcomes (APOs) with mild cognitive impairment (MCI) and dementia in parous women.

APOs are associated with a higher risk of cerebrovascular disease in women, but it is less clear whether there is an independent association of APOs with MCI and dementia.

We searched PubMed, Web of Science, and EMBASE for papers published in any language between database inception and July 18, 2024. We included all studies reported MCI or dementia as outcomes and included women who experienced an APO, including hypertensive disorders of pregnancy, gestational diabetes, stillbirth, fetal growth restriction, preterm birth, or placental abruption, during a pregnancy lasting ≥ 20 weeks. We excluded studies focused on men, nulliparous women, women with pre-pregnancy conditions associated with abnormal cognition, or those examining cognitive impairment within six months of pregnancy. The study protocol was prospectively registered with PROSPERO (CRD42023453511).
Of the 11,251 references identified, 15 studies including 7,347,202 participants met inclusion criteria. Only one study reported MCI as an outcome, while 11 studies (6,263,431 participants) examining dementia had sufficient data for meta-analysis. A history of any APO was associated with higher risk of all-cause dementia (HR 1.32, 95% CI 1.17, 1.49, I²= 80.4%), Alzheimer’s disease (HR 1.26, 95% CI 1.04, 1.53, I²=62.8%), and vascular dementia (HR 1.94, 95% CI1.70, 2.21 , I²=0%). A history of any hypertensive disorder of pregnancy was significantly associated with all-cause dementia (HR 1.32, 95% CI 1.11, 1.57) and vascular dementia (HR 1.78, 95% CI 1.46, 2.17), but not Alzheimer’s disease (HR 1.24, 95% CI 0.98, 1.57).
In the largest, most comprehensive meta-analysis to date, women with a history of any APOs had a significantly increased risk of future dementia with a moderately increased risk for Alzheimer’s disease and nearly double the risk of vascular dementia.
Authors/Disclosures
Eliza C. Miller, MD (University of Pittsburgh)
PRESENTER 		Dr. Miller has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for medical malpractice cases. The institution of Dr. Miller has received research support from National Institutes of Health. Dr. Miller has a non-compensated relationship as a member of ASA Advisory Council with American Heart Association/American Stroke Association that is relevant to AAN interests or activities.
Mohammad Alirezaei, MD (Columbia University Medical Center) Dr. Alirezaei has nothing to disclose.
Patrick Conley (Cedars-Sinai Medical Center) Patrick Conley has nothing to disclose.
Katrin Wolfova, MD, PhD (Charles University) Dr. Wolfova has received research support from Fulbright Commision.
Mitzi Gonzales, PhD Dr. Gonzales has stock in abbvie. The institution of Dr. Gonzales has received research support from NIH.
zaldy S. Tan, MD Dr. Tan has nothing to disclose.
Sarah Tom, PhD The institution of Dr. Tom has received research support from National Institutes of Health . Dr. Tom has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Alzheimer's Association .
Lynn Yee, MD Dr. Yee has nothing to disclose.
Adam Brickman, PhD Adam Brickman, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for IQVIA. Adam Brickman, PhD has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cognito Therapeutics. Adam Brickman, PhD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Illinois. Adam Brickman, PhD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for NovoNordisk. Adam Brickman, PhD has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Alzheimer's & Dementia. Adam Brickman, PhD has stock in Tau Biosciences. Adam Brickman, PhD has stock in CogniScreen.
Natalie Bello (Cedars-Sinai Medical Center) Natalie Bello has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for CRF. The institution of Natalie Bello has received research support from NIH.