Cognitive Function and Brain Structure Early Postpartum in Women with Preeclampsia
Description: Preeclampsia (PE), a pregnancy disorder characterized by de novo hypertension and systemic organ dysfunction that affects an estimated 3-6% (~300,000/yr) of pregnancies in the U.S., is a key risk factor for long-term maternal cardiovascular and cerebrovascular disease. Indeed, women with a history of PE have more than a three-fold greater risk for vascular dementia compared with healthy pregnancy (HP). Consistent with this, women with a history of PE exhibit cerebral white matter (WM) hyperintensity burden, a neuroimaging feature indicative of focal cerebral ischemic damage, and lower cognitive performance compared with women with a history of HP 1-3 years after pregnancy. Despite the clear links between PE history and maternal brain health, the cardiovascular and cerebrovascular mechanisms underlying early structural and functional brain aging in women with a history of PE are unknown. Early brain aging in women with a history of PE may be related in part to persistent central artery stiffness (e.g., aorta and carotid arteries) compared with HP controls in the postpartum period. Indeed, age-related central artery stiffness is an independent determinant of structural brain aging and cognitive decline, mediated in part through cerebrovascular mechanisms. Importantly, common carotid artery (CCA) stiffness is a more sensitive predictor of early age-related alterations in brain structure and function with aging than aortic stiffness. Therefore, the objective of this study is to investigate the CCA hemodynamic and cerebrovascular mechanisms contributing to cerebral target-organ damage and postpartum reductions in cognitive performance in women with a history of PE. Our central hypothesis is that greater CCA stiffness is linked to cerebral WM damage, mediated in part by cerebrovascular dysfunction, ultimately contributing to accelerated brain aging in young women with a history of PE. Aim 1: Determine the extent to which central artery stiffness and pressure pulsatility are associated with cerebral WM microstructural alterations and lower cognitive performance in young women with a recent history of PE compared with HP. Aim 2: Examine the degree to which cerebrovascular dysfunction contributes to altered WM structure and cognitive and cognitive performance in young women with a recent history of PE compared with HP. The proposed work is uniquely aligned with the AHA's primary impact goals to reduce cardiovascular and cerebrovascular disease risk in women.
Funder: American Heart Association
Amount: $300,000
Funding type: research
Funder scheme: Transformational Project Award
Start date: 2022-07-01
End date: 2025-06-30
Investigators: Gary Pierce, Gary Pierce
Institution: The University of Iowa
Funded outputs count: 4
Funder award ID: 969732
OpenAlex ID: G1955882655