Blood pressure care after giving birth could protect brain health

Women with high blood pressure in pregnancy may protect their brain health through better blood pressure management after giving birth, research has found.

Women who monitored and managed their blood pressure at home, with remote doctor support, had larger white matter volumes nine months after birth than those receiving standard postnatal care.

White matter links different brain regions; lower volumes have been associated with cognitive decline and conditions such as dementia.

The research, part of the NIHR Oxford Biomedical Research Centre-supported POP HT (Physician Optimized Postpartum Hypertension Treatment) trial led by Oxford researchers, suggests that improving blood pressure control soon after birth could make a difference.

Dr Winok Lapidaire is first author and principal investigator in cardiovascular medicine in the University of Oxford’s Radcliffe Department of Medicine.

The researcher said: “The study found that short-term postpartum optimisation of blood pressure after a hypertensive pregnancy was associated with larger brain volumes in the first year after the birth.

“Although the study did not assess long term outcomes, brain volume is a recognised marker of brain health and resilience to future decline.

“Our findings suggest that those early months after childbirth are an important window for supporting postpartum brain health and reducing the risk of future health problems in women who experienced hypertensive pregnancy.”

High blood pressure conditions in pregnancy, such as gestational hypertension (high blood pressure that develops during pregnancy) and pre-eclampsia (high blood pressure with protein in the urine), are linked to higher long-term risks of stroke, dementia and other neurological problems.

Earlier studies show women with these histories often have smaller brain volumes long after pregnancy.

Participants had either gestational hypertension or pre-eclampsia and required medication on discharge from hospital. Half self-monitored at home with remote clinical support; the rest received usual postnatal care.

Key finding: the self-management group had significantly larger white matter volumes at nine months than those given usual care.

Among women receiving standard care, those with previous pre-eclampsia showed smaller volumes in several structures than those with gestational hypertension.

These differences were not seen in the doctor-directed self-management group, suggesting improved control may offset effects associated with pre-eclampsia.

Earlier research by the POP HT team found that self-monitoring blood pressure after giving birth could help cut new mothers’ future risk of heart disease and strokes.