Women who experience gestational hypertension, preeclampsia, or eclampsia during pregnancy may show elevated risks of neurologic disorders postpartum, according to a new study.

In the Swedish cohort study of 648,385 women, published in JAMA Neurology, investigators followed participants for up to 15 years, revealing a range of risks associated with pregnancy-related hypertensive disorders.

The findings demonstrated that women with gestational hypertension had a 27% higher risk (adjusted hazard ratio [HR] = 1.27, 95% confidence interval [CI] = 1.12–1.45) of developing neurologic disorders compared with normotensive pregnancies. Those with preeclampsia had a 32% increased risk (adjusted HR = 1.32, 95% CI = 1.22–1.42), and eclampsia was linked to a 70% increased risk (adjusted HR = 1.70, 95% CI = 1.16–2.50). Women with eclampsia demonstrated more than a fivefold increased risk (adjusted HR = 5.31, 95% CI = 2.85–9.89) of developing epilepsy.

The study also found that preterm preeclampsia carried a higher risk (adjusted HR = 1.54, 95% CI = 1.34–1.79) for neurologic outcomes compared with term preeclampsia (adjusted HR = 1.27, 95% CI = 1.17–1.38).

The study used high-quality Swedish national registers, covering over 5 million person-years of follow-up. The investigators noted limitations as a result of the exclusion of primary care diagnoses for conditions like migraines and headaches, potentially underestimating true incidence rates. However, diagnoses of epilepsy were robustly captured through specialist referrals.

This comprehensive analysis underscored the need for heightened neurologic monitoring in women with a history of hypertensive pregnancy disorders.

Conflict of interest disclosures can be found in the study.