Polycystic Ovary Syndrome and the Risk of Eclampsia and Maternal Cognitive Impairment: A Population-Based Cohort Study

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder associated with insulin resistance, chronic inflammation, and endothelial dysfunction in women. These abnormalities may increase the risk of hypertensive disorders during pregnancy and subsequent neurological complications. This study evaluated the association between PCOS, eclampsia, and cognitive impairment in women.

Methods: We conducted a narrative review and integrative analysis of studies retrieved from PubMed, Scopus, and Web of Science. Observational studies, clinical investigations, and mechanistic research examining polycystic ovary syndrome, hypertensive disorders of pregnancy, neurological complications, and cognitive outcomes were qualitatively synthesized in this review.

Results: Women with PCOS exhibited a higher risk of gestational hypertension, preeclampsia, and eclampsia than those without PCOS. Insulin resistance, obesity, chronic inflammation, oxidative stress, and endothelial dysfunction are major contributors to vascular and placental abnormalities. Severe hypertensive disorders during pregnancy are also associated with impaired memory, executive dysfunction, reduced attention, and cerebrovascular injury. Shared inflammatory and vascular pathways may explain the relationship between PCOS, eclampsia, and cognitive impairments.

Conclusion: PCOS may be an important risk factor for eclampsia and subsequent cognitive impairment through interconnected metabolic, inflammatory, and endothelial pathways. Early identification and multidisciplinary management may reduce maternal complications and improve long-term neurological outcomes.