“Pregnancy Brain”: A Review of Cognitive Changes in Pregnancy and Postpartum

Abstract

Importance The idea that pregnant women suffer from deficits in memory is widespread but poorly documented in obstetrical literature. Objective To review available psychology literature on the subject of cognitive changes in pregnancy in order to guide the prenatal care provider on how to counsel pregnant women. Evidence Acquisition An extensive review of PubMed and PsycINFO databases was conducted to gather and analyze relevant studies on cognitive changes in pregnancy. Results A large body of literature examining basic science and animal studies support the effects of pregnancy hormones in remodeling brain architecture and neural function. However, studies in humans are hampered by small sizes, heterogeneous methodology, and varying definitions of memory. Nevertheless, the consensus among researchers is that pregnancy does confer deficits in working memory relative to nonpregnant controls. Conclusions and Relevance Cognitive effects of pregnancy are likely small, and the impact on daily life is debatable. Further research is needed to determine whether these effects may confer an advantage to parous women comparable to that seen in lower mammals. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After reading this article, readers should be better able to explain prior research into the incidence of brain-related changes brought on by pregnancy; identify different types of cognition and memory that may be affected by pregnancy; and anticipate questions and appropriately counsel pregnant patients about concerns regarding cognitive changes.

Evidence of subjective, but not objective, cognitive deficit in new mothers at one-year postpartum

“…Consistent with the anecdotal and self-report literature 8,9,13,15,27,28 , we hypothesised that mothers would self-report worse subjective memory than non-mothers but out-perform non-mothers in objective tests of cognitive performance.…”

“…The copyright holder for this preprint this version posted June 7, 2021. ; https://doi.org/10.1101/2021.06.07.447303 doi: bioRxiv preprint of cognitive difficulties related to pregnancy and parenthood that do not necessarily resolve upon the birth of the child 8,9,13,15,27,28 . Indirect evidence from neuroimaging studies suggests that the maternal brain undergoes dynamic plastic changes during pregnancy and the postpartum period which may be indicative of cognitive changes.…”

The effect of pregnancy on maternal cognition

“…A recently published review of cognitive changes in pregnancy and postpartum that analyzed a substantial number of studies in animals and humans, found that there is little agreement on the type and the degree of memory impairment 37 . Cognitive performance seems to be diminished rather than enhanced in humans, whereas animal research overwhelmingly supports enhanced memory function during pregnancy.…”

Gestational Folic Acid Administration Alleviated Maternal Postpartum Emotional and Cognitive Dysfunction in Mice

“…The hippocampus plays a central role in the processing of emotional and cognitive behaviors (Korotkova et al, 2018). Unlike general major depression disorder and cognitive impairment, with pathogenic mechanisms associated with psychosocial stress or neurological injury, postpartum symptoms are often speculated to be caused by hormonal fluctuations (Becker et al, 2016;Brown and Schaffir, 2019). A growing number of studies have shown that hippocampus-related mechanisms are implicated in the pathogenesis of postpartum emotional and cognitive dysfunction (Pawluski and Galea, 2007;Baka et al, 2017).…”