The Study Of Cognitive Changes In Patients With Hypertensive Disorders In Pregnancy

Objective:To study the cognitive changes in patients with gestational hypertension and pre-eclampsia,and further explore the correlation between hypertension and cognitive changes.Methods:Data were derived from pregnant women from January 2017 to December 2018,who attended regular prenatal health examination in community health service center of Wuxi New District and Wuxi Maternal and Child Care Hospital.The experimental group was divided into two subgroups:36 women in gestational hypertension group and 31 women in pre-eclampsia group.Meanwhile,another 30 normal pregnant women were selected as the control group,who were matched with the experimental group in the educational level and age.All subjects were performed with the Mini Mental State Scale(MMSE)and the Montreal Cognitive Assessment Scale(MoCA),and followed by the Digit-span Test and the Digital Connection Test around 35 weeks of gestation.In addition,all subjects must complete the Depression Questionnaire(PHQ-9).Meanwhile,Clinical data which included maternal age,blood pressure,height,body mass,blood sugar,living function and urinary protein were collected.Statistical methods:SPSS 22.0 software was used for statistical analysis.One-Way ANOVA test was used to compare the normal distribution measurement data among the three groups,and Kruskal-Wallis H test was used to compare the non-normal distribution measurement data among the three groups.Correlation analysis was performed by the Spearman test.Results:(1)There was no significant difference in educational level,age,weight and blood sugar among the three groups.Systolic and diastolic blood pressure in gestational hypertension group and pre-eclampsia group were significantly higher than those in control group[respectively(154.09±9.79)?(155.10±11.55)VS(111.93±10.79),both P<0.01;(93.27±11.22)?(94.83±10.69)VS(70.48±10.77),both P<0.01].(2)There was no difference in Short-term memory measured by MMSE test between gestational hypertension group and control group;The scores of attention and calculation,short-term memory and delayed memory of normal pregnant women were higher than those of pre-eclampsia group[respectively(4.61+0.49)VS(4.10+0.80),(3.00+0.00)VS(2.66+0.63),(2.74+0.44)VS(2.01+0.64),all P<0.001].The score of short-term memory in pre-eclampsia group was significantly lower than that in gestational hypertension group[(2.66±0.63)VS(2.83±0.37),P<0.05].(3)Compared with control group,the scores of visual space and executive function,attention and delayed memory were significantly lower in gestational hypertension and preeclampsia group,who were measured by MoCA test[respectively(4.0610.73)?(3.46±0.90)VS(4.90±0.30);(4.36±0.76)?(4.16±0.64)VS(5.30±0.65);(2.87±0.63)?(2.80±0.80)VS(3.90±0.71),all P<0.001];The scores of visual space and executive function in pre-eclampsia group were lower than those of hypertensive pregnancy group[(3.46±0.90)VS(4.06±0.73),P<0.05].(4)In gestational hypertension group and preeclampsia group,Digit-span Test scores were significantly lower than those in the control group[respectively(11.3 3±1.31)?(11.13±1.40)VS(13.54±1.35),both P<0.05].The time of digital connection test in the pregnancy-induced hypertension and preeclampsia groups was significantly longer than that in the control group[respectively(62.23±14.86)?(72.93±17.32)VS(44.36±15.38),both P<0.001)].The time of connection test in pre-eclampsia group was longer than that in gestational hypertension group[(72.93±17.32)VS(62.23±14.86),P<0.01].(5)The scores of Digit-span Test,visual space and executive function,delayed memory and the time of connection test were negatively correlated with systolic blood pressure(r=-0.740,-0.710,-0.336,-0.845,all P<0.001)and diastolic blood pressure(r=-0.762,-0.825,-0.261,-0.886,all P<0.05).Conclusion:Patients with pregnancy-induced hypertension and preeclampsia not only have poor memory and attention,but also have decreased visual space and executive ability.Moreover,the level of memory,attention and visual space and executive ability is negatively correlated with systolic and diastolic blood pressure.Therefore,doctors should pay attention to the changes of cognition of hypertensive disorders in pregnancy.