Assessment of association between pregnancy induced hypertension and cognitive function: Before and after one month of delivery: Cohort study

Abstract

Introduction: Pre-eclampsia is a leading cause of morbidity and death in mother and baby. This also leads to endothelial dysfunction in large and small vessels, which leads to cognitive impairment. This is the first kind of study from India on the assessment of cognitive function in the Pregnancy-induced hypertension (PIH) group. Materials and Method: We recruited cases from the obstetric department’s antenatal care. We applied Socio-demographic data and a Cognitive assessment battery (Trail Making Test (TMT) A and B, PGI memory scale, Porteus maze, and Digit Symbol Substitution Test (DSST)) to collect information on cognitive function. The data was collected from May 2021 to November 2021. Assessment was done during pregnancy and one month after Delivery. Data was assessed using SPSS software. Results: The TMT A and B values were 27.32 & 57.08 predelivery and 23.34 & 48.74 post-delivery. In PGI memory scale (pre and post-delivery values), Remote memory (6.76 & 6.81), recent memory (4.99 & 5.00), mental balance (6.26 &6.75), attention and concentration(7.42 & 8.27), delayed recall (6.29 &6.9), immediate recall(5.13 & 5.70), verbal retention-dissimilar word (9.52 & 10.18) and recognition (6.75 & 7.62) & DSST (88.0 & 91.31), verbal retention for similar words (5.19 &5.34 &)and visual (2.19 & 2.22) retention. The Maze Test-1 (17.29 & 13.06) Maze Test-2 (21.44 & 16.83). Before Delivery, cognitive impairment was present in the Pregnancy Hypertension (PIH) group in trail making, MAZE test, and certain areas of the PGI memory scale, which were statistically significant (<0. 001) compared to the healthy control group. It continues even after one month of Delivery. Conclusion: This study has shown that there was an association between the pregnancy-induced hypertensive group and the healthy control group in certain domains of cognitive function before Delivery. The cognitive impairment persists even after one month of Delivery, which signifies microvascular damage persists for a longer duration.