Pregnancy and Alzheimer's disease: Understanding maternal and neonatal neurological risks

Alzheimer's disease (AD) is the foremost cause of dementia globally, marked by progressive neurological decline and cognitive impairment. Risk arises from complex interactions between genetic and environmental factors. This review examines how prenatal health influences long-term brain outcomes in both mothers and offspring. Pregnancy triggers significant hormonal, immunological, and physiological changes that support fetal development but also increase the risk of complications such as gestational diabetes and preeclampsia. These conditions promote chronic inflammation, vascular dysfunction, and brain alterations associated with AD and vascular dementia. Maternal cardiovascular and metabolic health critically affect neurodevelopment and cognitive aging across generations. Postpartum hormones, notably progesterone and estrogen, provide neuroprotective and anti-inflammatory effects that may mitigate neurodegeneration. Additionally, reproductive factors including parity and reproductive lifespan modulate women's risk of AD. The immune adaptations and inflammatory processes during pregnancy further contribute to neurodegenerative pathways. This review highlights the importance of optimizing maternal health, implementing early detection of cognitive risks, and fostering interdisciplinary collaboration to improve outcomes. Integrating obstetric, neurological, and psychiatric care can enhance prevention and management strategies. Ultimately, these insights underscore the need for public health initiatives targeting maternal and offspring brain health to reduce the burden of neurological diseases over the lifespan.