Elsevier

Hormones and Behavior

Volume 74, August 2015, Pages 218-227
Hormones and Behavior

Working memory in pregnant women: Relation to estrogen and antepartum depression

https://doi.org/10.1016/j.yhbeh.2015.07.006Get rights and content

Highlights

  • Working memory tested in pregnant women and matched non-pregnant controls

  • Depression status assessed by questionnaire and clinician interview

  • Only pregnant women showing depressive symptoms had reduced working memory.

  • Severity of depressive affect and serum estradiol levels predicted working memory.

  • Higher estradiol associated with better working memory during pregnancy.

Abstract

This article is part of a Special Issue “Estradiol and cognition”.

Subjective changes in concentration and memory are commonly reported by women during the second or third trimesters of pregnancy, but the nature of the problem is poorly understood. We hypothesized that these self-reports might reflect difficulties in working memory (WM). It was further hypothesized that antepartum depression (depression arising during pregnancy) may play an etiological role, either on its own or due to secondary changes in endocrine function or sleep. Using WM tasks that emphasized executive control processes mediated by the prefrontal cortex (PFC) we compared pregnant women tested at 34–36 weeks of gestation (n = 28) with age- and education-matched non-pregnant controls (n = 26). All pregnant women were screened for depression. Evidence of a WM disturbance was found, and was evident only among pregnant women showing depressive symptoms. In contrast, pregnant women who were not depressed showed WM performance that equalled, or even significantly exceeded, non-pregnant controls. No significant differences were observed on control tests of other cognitive functions. Multiple regression revealed that serum estradiol concentrations, along with severity of depressive affect but not sleep disruption, significantly predicted variation in the WM scores. In agreement with studies of estradiol and WM in other contexts, higher estradiol was associated with better WM, while higher levels of depressive symptoms predicted poorer WM. We conclude that memory disturbance during gestation might not be as widespread as commonly believed, but can be seen among women experiencing antepartum depression. The high level of WM performance found in healthy, non-depressed, pregnant women is discussed from an adaptationist perspective.

Section snippets

Participants

Participants consisted of 28 pregnant women (Preg, n = 28) tested in the third trimester of pregnancy, and two groups of age- and education-matched controls (see Table 1). One control group consisted of non-pregnant nulliparous women (NonPreg, n = 26) and was used to establish whether any reduction in WM could be identified in the pregnant group. To further probe for any evidence of impairment, we recruited a second control group made up of age- and education-matched postpartum controls (PostPart, n

Results

The total number of WM errors produced on the SPWM and the SOP was well-correlated (r = .58, p < .001), consistent with their shared working memory demands. ANOVAs revealed a parallel pattern of group differences on the 2 tasks, as described below.

Discussion

In keeping with the possibility that WM is disrupted during the second or third trimesters of pregnancy, we found a medium to large effect (Cohen's d) on tests of WM but not on a test of explicit memory in pregnant women. The effect was seen only in women exhibiting antepartum depression. Specifically, significantly diminished WM was evident in the Preg + group relative to pregnant women tested at a matched point in gestation who were not depressed (Preg −) and relative to non-pregnant controls

Conclusions

Our data suggest that memory disturbance during gestation (GMI) does occur in certain women, but is not a feature of all pregnancies. We identify depression in the antepartum period as a potential risk factor for GMI. We found an effect in the domain of WM, but whether or not there is any adverse effect of pregnancy on explicit memory, and under what conditions, remains an unresolved question. Not all women showed reduced memory. To the contrary, a high level of WM proficiency was detected in

Acknowledgments

This work was supported by a pilot grant from the Society for Women's Health Research through its Isis Fund Network (EH, WS, MS) and by a grant to the first author from the Natural Sciences and Engineering Research Council of Canada (RGPIN 138017-2009) and to author WS from the National Institutes of Health (U01 GM092655). EH held a Chair in Women's Health from the Canadian Institutes of Health Research and Ontario Women's Health Council. We thank M. Coote for her assistance with the

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