Higher anxiety and depressive symptoms were associated with greater self-reported cognitive difficulties during pregnancy and early postpartum, while meeting prenatal physical activity guidelines appeared to weaken the association between depressive symptoms and cognitive failures. Physical activity alone was not significantly associated with self-reported cognitive failures at either assessment.
Researchers analyzed data from 56 pregnant women participating in a longitudinal study in central Pennsylvania. Participants completed assessments at 28 to 30 weeks of gestation, and 46 of 56 participants (82%) completed follow-up assessments approximately 6 weeks postpartum. Their mean age was 30.1 years, and most were White (98%), married (91%), and college-educated (63%). Participants were recruited through an obstetrics and gynecology practice.
The study assessed self-reported cognitive failures, including forgetfulness, distractibility, and unintended actions, using the 25-item Cognitive Functioning Questionnaire (CFQ). Anxiety symptoms were measured using the State-Trait Anxiety Inventory, and depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Investigators evaluated weekly physical activity using the Leisure-Time Exercise Questionnaire, classifying participants according to whether they met guidelines of at least 150 minutes of moderate-to-vigorous physical activity per week. General linear models examined associations between physical activity, mood symptoms, and cognitive failures, while exploratory analyses assessed whether physical activity modified the relationships between mood symptoms and cognitive functioning.
Women with higher-than-average anxiety symptoms during both pregnancy and postpartum (n = 14) reported greater cognitive difficulties than those with consistently lower anxiety symptoms (n = 21). Mean CFQ scores were 48.1 vs 33.0 during pregnancy and 43.1 vs 28.8 postpartum, with statistically significant differences across anxiety groups at both time points. These differences extended across all 3 CFQ subscales.
Depressive symptoms were associated with cognitive difficulties, although the findings varied by assessment period. Women with higher-than-average depressive symptoms at both time points had mean CFQ scores of 43.4 during pregnancy and 39.5 postpartum, compared with 33.7 and 28.2, respectively, among women with consistently lower symptoms. The association between depressive symptom groups and total cognitive failures was statistically significant postpartum but not during pregnancy. However, women with persistently higher depressive symptoms reported greater forgetfulness and unintended actions during both periods.
Meeting physical activity guidelines was not independently associated with statistically significant differences in cognitive functioning. Women who met the guidelines during both pregnancy and postpartum (n = 10) had mean CFQ scores of 36.6 and 30.6, respectively, compared with 40.9 and 37.8 among women who did not meet the guidelines at either assessment (n = 23).
Exploratory analyses identified a statistically significant interaction between prenatal physical activity and depressive symptoms. As depressive symptoms increased, self-reported cognitive failures also increased, but at a slower rate among women who met prenatal physical activity guidelines compared with those who did not. The interaction between prenatal physical activity and anxiety symptoms was not statistically significant.
The postpartum findings differed. As anxiety symptoms increased, cognitive failures increased at a slower rate among women who did not meet postpartum physical activity guidelines compared with those who did. No statistically significant interaction was observed between postpartum physical activity and depressive symptoms. These findings suggested that physical activity may modify mood-related cognitive difficulties differently during pregnancy and postpartum, although the exploratory results do not establish a protective effect of physical activity.
The study had several limitations, including its small, predominantly White and relatively well-educated sample, which restricted generalizability. Physical activity and cognitive functioning were assessed through self-reported questionnaires rather than objective activity monitoring or neuropsychological testing, and the analyses did not adjust for potential confounders such as sleep quality, perceived stress, social support, maternal age, or parity. Anxiety and depressive symptom groups were defined using sample-based median thresholds rather than clinical diagnostic cutoffs. The observational design also prevented causal conclusions.
The findings highlight the importance of assessing anxiety and depressive symptoms during prenatal and postpartum care, particularly among patients reporting everyday cognitive difficulties. However, the observational results do not establish that physical activity improves cognition or that mood symptoms cause cognitive failures.
"Future research is needed to explore other potential moderators of the PA-cognition relationship, including sleep and social support," wrote lead study author Victoria A. Suhy, of the Exercise Psychology Laboratory in the Department of Kinesiology at Pennsylvania State University, and colleagues.
The authors declared no conflicts of interest. The study was supported in part by Pennsylvania State University's College of Health and Human Development Seed Grant Program.
Source: Psychology & Health
