Regional Distribution of Cerebral White Matter Lesions Years After Preeclampsia and Eclampsia

Wiegman, Marjon J. MD, PhD; Zeeman, Gerda G. MD, PhD; Aukes, Annet M. MD, PhD; Bolte, Antoinette C. MD, PhD; Faas, Marijke M. PhD; Aarnoudse, Jan G. MD, PhD; de Groot, Jan C. MD, PhD

doi: 10.1097/AOG.0000000000000162
Contents: Original Research

OBJECTIVE: To assess the distribution of cerebral white matter lesions in women who had eclampsia, preeclampsia, or normotensive pregnancies. The pathophysiology of these lesions, more often seen in formerly eclamptic and preeclamptic women, is unclear but may be related to a predisposition for vascular disease, the occurrence of the posterior reversible encephalopathy syndrome, or both while pregnant. Assessing the distribution of such lesions may give insight into their pathophysiology and possible consequences.

METHODS: This retrospective cohort study determined the presence, severity, and location of white matter lesions on cerebral magnetic resonance imaging scans of 64 formerly eclamptic, 74 formerly preeclamptic, and 75 parous control women.

RESULTS: Formerly preeclamptic and eclamptic women have white matter lesions more often (34.4% [n=47] compared with 21.3% [n=16]; P<.05) and more severely (0.07 compared with 0.02 mL; P<.05) than parous women in a control group. In all women, the majority of lesions was located in the frontal lobes followed by the parietal, insular, and temporal lobes.

CONCLUSION: White matter lesions are more common in women with prior pregnancies complicated by preeeclampsia or eclampsia compared with parous women in a control group. In no group does regional white matter lesion distribution correspond to the occipitoparietal edema distribution seen in posterior reversible encephalopathy syndrome.

LEVEL OF EVIDENCE: II

Cerebral white matter lesions years after preeclampsia or eclampsia are located mainly in the frontal lobes.

School of Behavioural and Cognitive Neurosciences, Department of Obstetrics and Gynecology, the Division of Medical Biology, Department of Pathology and Medical Biology, and the Department of Radiology, University of Groningen, University Medical Center Groningen, and the Department of Obstetrics and Gynaecology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.

Corresponding author: Marjon J. Wiegman, MD, PhD, University Medical Center Groningen, Department of Dermatology, Hanzeplein 1, 9700 RB Groningen, The Netherlands; e-mail: mj.wiegman@umcg.nl.

The authors thank Jim van Eyck for contributing to the recruitment of participants and Henk Groen for his help with the statistical analyses.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.