Adverse Pregnancy Outcomes and Cognitive Change in Older Women.

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.