Pregnancy and puerperium imply neuropsychological changes in women: A prospective cohort study

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Background Pregnancy and the postpartum period involve substantial neurobiological and psychological changes. Although subjective complaints such as forgetfulness and mental fatigue are common, empirical evidence regarding objective cognitive changes remains inconsistent. This study aimed to longitudinally characterize cognitive trajectories from early pregnancy through the postpartum period in healthy women. Methods We conducted a prospective, longitudinal cohort study (2018–2024). Fifty healthy women underwent four consecutive neuropsychological assessments: once during each trimester of pregnancy and one month after partum. The neuropsychological assessment evaluated memory, attention, processing speed, and executive functions. Participants also completed self-reported measures of fatigue, emotional status, and quality of life. Repeated-measures analyses were employed to account for intra-individual variability. Results Working memory improved significantly during the second trimester ( p =.013) and postpartum ( p =.006) compared to the first trimester. Processing speed showed a transient decline during pregnancy but improved significantly postpartum ( p =.020). Executive functions, specifically cognitive flexibility ( p =.032) and verbal fluency (p=.032), showed a statistically significant improvement after delivery. Learning capability, long-term memory, and attention span remained stable throughout the study. Interestingly, despite increased self-reported postpartum fatigue ( p = .031), no negative effect on cognitive performance was observed. Conclusions Our findings suggest that the transition to motherhood is characterized by selective cognitive enhancement, particularly in executive functioning and working memory, rather than generalized decline. These fluctuations likely reflect adaptive neuroplastic processes. Although subjective fatigue is prevalent postpartum, it does not appear to translate into objective cognitive impairment.

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