The effect of obesity on cognitive function, anxiety and depression in pregnant patient during regional anesthesia

Abstract

Background. A number of studies have associated aggravation of cognitive impairment, anxiety and depression in pregnant women with anesthesia. In addition, obesity during pregnancy itself is associated with an increased risk of developing these complications.The objective was to study the effect of obesity on cognitive function, anxiety and depression in pregnant women during regional anesthesia.Materials and methods. The study included 70 pregnant women who were admitted for planned delivery. Patients were divided into two groups: obese pregnant women (BMI≥ 30) (n = 35) and pregnant women with normal weight (BMI < 30) (n = 35). All patients underwent surgery under spinal anesthesia. The indicators of cognitive function, anxiety, and depression were evaluated using specially selected tests before surgery and on the third day of the postoperative period.Results. The development of obesity during pregnancy was accompanied by an impairment of cognitive functions. After surgery, in the BMI≥ 30 group, cognitive function according to the MOS test decreased from 25.1 (25.9; 24.2) to 24.3 (25.2; 23.4) points (p = 0.004), and in the BMI < 30 group, there were no statistical differences – 26.3 (27.1; 25,5) and 25.6 (26.5; 24.7) points (p = 0.071). In addition, the baseline indicators of anxiety and depression in obese pregnant women were higher in comparison with pregnant women with normal weight (p < 0.001). Performing a cesarean section under spinal anesthesia in all patients led to a decrease in anxiety and an increase in depression in the BMI≥ 30 group from 7.2 (8.1; 6.7) to 6.9 (7.5; 6.3) points (p = 0.004), and in the BMI < 30 group – from 6.5 (6.8; 6.2) to 6.1 (6.5; 5.7) points (p = 0.038).Conclusion. The presence of obesity during pregnancy was revealed in combination with impairment of cognitive functions even before surgery, after delivery under spinal anesthesia, cognitive dysfunction increased.