Download PDF
Am J Perinatol 2019; 36(03): 285-290
DOI: 10.1055/s-0038-1667376
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Association between Depressive State and Maternal Cognitive Function in Postpartum Women

Elad Mazor
1   Faculty of Health Sciences, The Joyce and Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Eyal Sheiner
2   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Tamar Wainstock
1   Faculty of Health Sciences, The Joyce and Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Monic Attias
2   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
,
Asnat Walfisch
2   Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
› Author Affiliations Funding None.
Further Information

Publication History

19 September 2017

01 July 2018

Publication Date:
06 August 2018 (online)

    Permissions and Reprints

Abstract

Objective Maternal amnesia is a transitional cognitive impairment occurring during pregnancy and the postpartum period. We evaluated the prevalence and extent of this suggested cognitive decline and the role of postpartum depression.

Study Design A cross-sectional study was performed in women during the immediate postpartum period. Eligible women completed the Edinburgh Postnatal Depression Scale (EPDS). Cognitive function was assessed using an objective neurocognitive test (Symbol Digit Modalities Test, SDMT90, and SDMT4) and a subjective self-estimation questionnaire (Attention Function Index [AFI]).

Results A total of 120 women completed the study questionnaires; 33.3% (40 women) exhibited signs of postpartum depression (EPDS ≥10). The subjective AFI test results correlated with the objective SDMT90 test results (r 2 = 0.2, p = 0.039). Depressed mothers scored significantly lower in the subjective AFI test (67.69 ± 12.01 in the study vs. 79.05 ± 14.3 in the comparison group; p < 0.001) and nearly significantly lower in the objective SDMT test (p = 0.057). In the multi-variable model, maternal depression was independently associated with the subjective AFI score (β  = −13.7; 95% confidence interval [CI]: −19.1 to −8.2, p < 0.001) but not with the objective SDMT score (β = −3.48; 95% CI −8.3 to 1.3, p = 0.15), while controlling for maternal age, gestational age, and ethnicity.

Conclusion Postpartum depression is common and appears to predominantly affect maternal self-assessment of cognitive ability, rather than a true cognitive impairment.

Keywords

postpartum depression - maternal amnesia - cognitive function - Edinburgh Postnatal Depression Scale

Note

This study was presented in part at the 38th Annual SMFM Pregnancy Meeting in Dallas, Texas, January 2018. This study was conducted as part of the requirements for graduation from the medical school of the Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.


 

  • References

  • 1 Macbeth AH, Luine VN. Changes in anxiety and cognition due to reproductive experience: a review of data from rodent and human mothers. Neurosci Biobehav Rev 2010; 34 (03) 452-467
    CrossrefPubMedGoogle Scholar
  • 2 Logan DM, Hill KR, Jones R, Holt-Lunstad J, Larson MJ. How do memory and attention change with pregnancy and childbirth? A controlled longitudinal examination of neuropsychological functioning in pregnant and postpartum women. J Clin Exp Neuropsychol 2014; 36 (05) 528-539
    CrossrefPubMedGoogle Scholar
  • 3 Keenan PA, Yaldoo DT, Stress ME, Fuerst DR, Ginsburg KA. Explicit memory in pregnant women. Am J Obstet Gynecol 1998; 179 (3 Pt 1): 731-737
    CrossrefPubMedGoogle Scholar
  • 4 Henry JF, Sherwin BB. Hormones and cognitive functioning during late pregnancy and postpartum: a longitudinal study. Behav Neurosci 2012; 126 (01) 73-85
    CrossrefPubMedGoogle Scholar
  • 5 Hampson E, Phillips SD, Duff-Canning SJ. , et al. Working memory in pregnant women: Relation to estrogen and antepartum depression. Horm Behav 2015; 74: 218-227
    CrossrefPubMedGoogle Scholar
  • 6 Crawley RA, Dennison K, Carter C. Cognition in pregnancy and the first year postpartum. Psychol Psychother 2003; 76 (Pt 1): 69-84
    CrossrefPubMedGoogle Scholar
  • 7 Yedid Sion M, Harlev A, Weintraub AY, Sergienko R, Sheiner E. Is antenatal depression associated with adverse obstetric and perinatal outcomes?. J Matern Fetal Neonatal Med 2016; 29 (06) 863-867
    CrossrefPubMedGoogle Scholar
  • 8 Grigoriadis S, VonderPorten EH, Mamisashvili L. , et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013; 74 (04) e321-e341
    CrossrefPubMedGoogle Scholar
  • 9 Wisner KL, Sit DK, Hanusa BH. , et al. Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry 2009; 166 (05) 557-566
    CrossrefPubMedGoogle Scholar
  • 10 Committee on Obstetric Practice. The American College of Obstetricians and Gynecologists Committee Opinion no. 630. Screening for perinatal depression. Obstet Gynecol 2015; 125 (05) 1268-1271
    CrossrefPubMedGoogle Scholar
  • 11 Moraes GP, Lorenzo L, Pontes GA, Montenegro MC, Cantilino A. Screening and diagnosing postpartum depression: when and how?. Trends Psychiatry Psychother 2017; 39 (01) 54-61
    CrossrefPubMedGoogle Scholar
  • 12 Silverman ME, Reichenberg A, Savitz DA. , et al. The risk factors for postpartum depression: A population-based study. Depress Anxiety 2017; 34 (02) 178-187
    CrossrefPubMedGoogle Scholar
  • 13 Ko JY, Rockhill KM, Tong VT, Morrow B, Farr SL. Trends in Postpartum Depressive Symptoms—27 States, 2004, 2008, and 2012. MMWR Morb Mortal Wkly Rep 2017; 66 (06) 153-158
    CrossrefPubMedGoogle Scholar
  • 14 Muliyala KP, Varghese M. The complex relationship between depression and dementia. Ann Indian Acad Neurol 2010; 13 (Suppl 2): S69-S73
    PubMedGoogle Scholar
  • 15 Denis A, Michaux P, Callahan S. Factors implicated in moderating the risk for depression and anxiety in high risk pregnancy. J Reprod Infant Psychol 2012; 30 (02) 124-134
    CrossrefPubMedGoogle Scholar
  • 16 Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150 (06) 782-786
    CrossrefPubMedGoogle Scholar
  • 17 Cattaneo MC, Roveraro S, Chiorino V. , et al. The behavior over time of postnatal depression symptomatology and its early detection via the Edinburgh Postnatal Depression Scale: An Italian longitudinal study. Int J Adv Nurs Stud 2015; 4 (01) 23
    PubMedGoogle Scholar
  • 18 Sheridan LK, Fitzgerald HE, Adams KM. , et al. Normative Symbol Digit Modalities Test performance in a community-based sample. Arch Clin Neuropsychol 2006; 21 (01) 23-28
    CrossrefPubMedGoogle Scholar
  • 19 Cimprich B, Visovatti M, Ronis DL. The Attentional Function Index--a self-report cognitive measure. Psychooncology 2011; 20 (02) 194-202
    CrossrefPubMedGoogle Scholar
  • 20 Glasser S, Stoski E, Kneler V, Magnezi R. Postpartum depression among Israeli Bedouin women. Arch Women Ment Health 2011; 14 (03) 203-208
    CrossrefPubMedGoogle Scholar
  • 21 García-Blanco A, Monferrer A, Grimaldos J. , et al. A preliminary study to assess the impact of maternal age on stress-related variables in healthy nulliparous women. Psychoneuroendocrinology 2017; 78: 97-104
    CrossrefPubMedGoogle Scholar
  • 22 Ihongbe TO, Masho SW. Do Successive Preterm Births Increase the Risk of Postpartum Depressive Symptoms?. J Pregnancy 2017; 2017 (17) 4148136
    PubMedGoogle Scholar
  • 23 Zlatar ZZ, Moore RC, Palmer BW, Thompson WK, Jeste DV. Cognitive complaints correlate with depression rather than concurrent objective cognitive impairment in the successful aging evaluation baseline sample. J Geriatr Psychiatry Neurol 2014; 27 (03) 181-187
    CrossrefPubMedGoogle Scholar
  • 24 Hohman TJ, Beason-Held LL, Resnick SM. Cognitive complaints, depressive symptoms, and cognitive impairment: are they related?. J Am Geriatr Soc 2011; 59 (10) 1908-1912
    CrossrefPubMedGoogle Scholar