Cerebral complications from preeclampsia and eclampsia are a major cause of maternal mortality and long-term neurological impact. Understanding pathophysiology (changes in how the body works as a result of disease) may help develop new strategies to protect the brains of pregnant and postpartum women. A research study examined blood-brain barrier injury and neuroinflammation in women with preeclampsia and eclampsia, comparing them to those with normal pregnancies. This comparison helps us better understand the associated neurological risks.

Researchers studied women having C-sections at Tygerberg Hospital in Cape Town, South Africa from March 2021 to June 2023. The study included 129 women: 11 had eclampsia, 17 had preeclampsia with end-organ complications, 88 had preeclampsia without complications, and 13 were healthy (normotensive). During the surgery, doctors collected blood and spinal fluid samples to check for any damage to the blood-brain barrier and signs of inflammation (swelling or irritation to the brain).

Women with eclampsia had much higher levels of certain proteins and signals in their brain fluid, showing that their brains were more inflamed. Women with preeclampsia also had changes, but not as strong. Women with preeclampsia who show early signs of blood-brain barrier damage and inflammation, might suggest they are at a higher risk of progressing to eclampsia. This study indicates that eclampsia can damage the brain’s protective barrier and cause serious brain inflammation. This may help explain why women with eclampsia have seizures or brain injuries.

Neuroinflammation and damage to the blood-brain barrier likely happen together and are triggered by problems in the blood vessels and changes in inflammatory responses. This resembles what occurs in various neurodegenerative diseases, such as traumatic brain injuries, stroke, and Alzheimer’s.

Take home message: Women who have eclampsia suffer from swelling to the brain and damage to its protective barrier. Healthcare providers should regularly follow up with women who have experienced eclampsia or postpartum eclampsia to monitor for any lasting brain or nerve problems. This is critical to ensure these women get the long-term support they need. Patients should also monitor any long-term neurological symptoms such as new or worsening migraines, epilepsy, confusion, or “brain fog” and inform their providers about their pregnancy history.

Link: https://pubmed.ncbi.nlm.nih.gov/40344719/

Citation: Bucher V, Herrock OT, Schell S, Visser J, Imberg H, Burke J, Zetterberg H, Blennow K, Walker SP, Tong S, Ek J, Cluver C, Bergman L. Blood-brain barrier injury and neuroinflammation in pre-eclampsia and eclampsia. EBioMedicine. 2025 Jun;116:105742. doi: 10.1016/j.ebiom.2025.105742. Epub 2025 May 8. PMID: 40344719; PMCID: PMC12136835.

About Research Roundup

Each quarter, our team of science writers reviews the most current research studies related to hypertensive disorders of pregnancy and summarizes those studies of greatest interest and potential impact to our community, including research studies related to risk assessment, diagnosis, prevention, and treatment. Special thanks to our volunteer research team including Dr. Sig-Linda Jacobson, Dr. Jennifer Mitchell, Dr. Julie Reynolds, Amanda Yang, and Simren Gupta who make Research Roundup possible, and to our Patient Advisory Council, who reviews these materials from the patient perspective.