Neurological lesions of the mother and the fetus in preeclampsia – an overview of the literature

Abstract

About 3-5% of pregnancies are complicated by preeclampsia (PE), a multisystem disorder of exact unknown etiology, characterized by new-onset hypertension (>140/90 mmHg), proteinuria, and/or evidence of organ dysfunction. Although it is not yet completely understood what causes PE, maternal and placental factors seem to be involved. Endothelial dysfunction, maternal vascular inflammation, and remodeling of spiral arteries during placentation seem to be the underlying mechanisms of this pregnancy-related disease. Acute PE neurological complications, such as eclamptic seizures, cerebral edema, and intracerebral hemorrhage, are responsible for more than 70% of maternal deaths. Furthermore, long-term complications, such as cognitive dysfunction, the elevated lifetime risk of cerebrovascular disease, and persistent white matter lesions increase the rate of PE-related maternal morbidity and mortality. Hypertensive disorders associated with pregnancy affect not only the mother but also the baby by restricting the supply of nutrients and oxygen to the fetus. This has been associated with impaired cognitive development in children, increased lifetime cerebrovascular, cardiovascular, and metabolic risk, low intelligence quotient (IQ) and mental development indices (MDI), and more depression symptoms later in life. This study aims to review the literature and synthesize available information about preeclampsia and its neurological consequences on both the mother and the fetus.