Abstract
Objective
Maternal amnesia is described as a transitional cognitive impairment during pregnancy and the postpartum period. We aimed to evaluate the prevalence and extent of this suggested cognitive decline, both objectively and subjectively, and determine whether peripartum depression plays a role.
Study Design
A cross-sectional study was performed in women during the immediate post-partum period. Only singleton, term, and uncomplicated vaginal deliveries were included. Eligible women completed the Edinburgh postnatal depression scale (EPDS), a valid screening test for postpartum depression. Cognitive function was assessed using an objective neurocognitive test (Symbol Digit Modalities Test, SDMT90) as well as a subjective self-estimation questionnaire (Attention Function Index; AFI). Cognitive assessments were compared between depressed and non-depressed women (EPDS ≥ or < than 10, respectively). The Pearson correlation test was employed for correlations between the different tests used, and a multivariable analysis controlled for relevant confounders. A sample of 96 women was calculated to be sufficient in order to detect a difference of 5 points in the SDMT90 test.
Results
A total of 120 women completed the study questionnaires; 33.3% (40 women) exhibited signs of depression (EPDS≥10). No significant differences were noted between the groups in pregnancy course and outcome (Table 1). Depressed mothers scored significantly lower in the subjective (AFI) test (mean self-assessment score - 67.69 in the study vs. 79.05 in the comparison group; p<0.001) and had a nearly significant lower score in the objective SDMT90 test (mean score - 42.51 in the study group vs. 47.27 in the comparison group; p=0.057, Table 2). The subjective AFI test results were correlated with the objective SDMT90 test results (r2=0.2, p=0.039). In the multivariable regression model, maternal depression was found to be independently and significantly associated with the subjective (AFI) score (adjusted OR 0.93, 95%CI 0.90-0.96, p<0.001), but not with the objective SMDT90 score (adjusted OR 0.97, 95%CI 0.93-1.01, p=0.15) while controlling for maternal age, gestational age, and ethnicity.
Conclusion
Peripartum depression is extremely common among postpartum women, and appears to mainly affect maternal self-assessment of cognitive ability, rather than true cognitive impairment.
Maternal amnesia is described as a transitional cognitive impairment during pregnancy and the postpartum period. We aimed to evaluate the prevalence and extent of this suggested cognitive decline, both objectively and subjectively, and determine whether peripartum depression plays a role.
Study Design
A cross-sectional study was performed in women during the immediate post-partum period. Only singleton, term, and uncomplicated vaginal deliveries were included. Eligible women completed the Edinburgh postnatal depression scale (EPDS), a valid screening test for postpartum depression. Cognitive function was assessed using an objective neurocognitive test (Symbol Digit Modalities Test, SDMT90) as well as a subjective self-estimation questionnaire (Attention Function Index; AFI). Cognitive assessments were compared between depressed and non-depressed women (EPDS ≥ or < than 10, respectively). The Pearson correlation test was employed for correlations between the different tests used, and a multivariable analysis controlled for relevant confounders. A sample of 96 women was calculated to be sufficient in order to detect a difference of 5 points in the SDMT90 test.
Results
A total of 120 women completed the study questionnaires; 33.3% (40 women) exhibited signs of depression (EPDS≥10). No significant differences were noted between the groups in pregnancy course and outcome (Table 1). Depressed mothers scored significantly lower in the subjective (AFI) test (mean self-assessment score - 67.69 in the study vs. 79.05 in the comparison group; p<0.001) and had a nearly significant lower score in the objective SDMT90 test (mean score - 42.51 in the study group vs. 47.27 in the comparison group; p=0.057, Table 2). The subjective AFI test results were correlated with the objective SDMT90 test results (r2=0.2, p=0.039). In the multivariable regression model, maternal depression was found to be independently and significantly associated with the subjective (AFI) score (adjusted OR 0.93, 95%CI 0.90-0.96, p<0.001), but not with the objective SMDT90 score (adjusted OR 0.97, 95%CI 0.93-1.01, p=0.15) while controlling for maternal age, gestational age, and ethnicity.
Conclusion
Peripartum depression is extremely common among postpartum women, and appears to mainly affect maternal self-assessment of cognitive ability, rather than true cognitive impairment.
| Original language | American English |
|---|---|
| Pages (from-to) | S531-S531 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 218 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2018 |