Adverse Pregnancy Outcomes and Cognitive Change in Older Women

J Womens Health (Larchmt). 2026 Jan;35(1):31-40. doi: 10.1177/15409996251383009. Epub 2025 Sep 29.

Abstract

Introduction: Whether the history of adverse pregnancy outcomes (APOs) contributes to cognitive decline in women is unclear.

Methods: Among parous female Adult Changes in Thought (ACT) participants (aged ≥ 65 years without dementia at enrollment), we abstracted APO history for those born 1940 or later and enrolled between 2005 and 2020 (n = 444). Generalized estimating equations estimated the association between APO history and cognition score, measured using the Cognitive Abilities Screening Instrument assessment using item response theory (CASI-IRT), and cognitive decline.

Results: Among all participants, 13% had a history of APO. In adjusted models, women with an APO history had 0.23-point lower CASI-IRT score at any age (95% confidence interval: -0.54, 0.07); this small difference was not statistically significant. We found no evidence of an association between APO history and 4-year cognitive change.

Conclusion: Among women in the ACT study born in 1940 or later, we found no evidence of a significant association between history of APO and lower cognition or cognitive decline in older adulthood.

Keywords: adverse pregnancy outcomes; cognition; cognitive decline; hypertensive disorders of pregnancy; maternal; preeclampsia; pregnancy; preterm birth.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition*
  • Cognitive Dysfunction* / epidemiology
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications* / epidemiology
  • Pregnancy Outcome* / epidemiology