Does pregnancy affect memory?

Pregnancy's Effect on Memory

Pregnancy is associated with objective memory deficits, particularly in recall memory and everyday prospective memory tasks, with the most significant impairment occurring during the third trimester. 1

Evidence of Memory Changes During Pregnancy

• Pregnant women experience objective deficits in memory, particularly in everyday life situations that may not be readily detected in laboratory settings 2
• Meta-analysis of 20 studies involving 709 pregnant women showed poorer overall cognitive functioning compared to non-pregnant women, with the most significant differences appearing in the third trimester 1
• Memory impairment during pregnancy affects specific types of memory differently:
  • Recall memory (remembering information without cues) is significantly impaired 3
  • Recognition memory (identifying previously encountered information) remains largely intact 3
  • Prospective memory (remembering to perform future tasks) shows deficits in real-world settings 2

Progression of Memory Changes Throughout Pregnancy

• Cognitive changes begin developing primarily during the first trimester 1
• Longitudinal studies show significant declines between the first and second trimesters in:
  • General cognitive functioning (SMD, 0.29 [95% CI, 0.08-0.50]) 1
  • Memory performance (SMD, 0.33 [95% CI, 0.12-0.54]) 1
• Third trimester shows the most pronounced deficits in:
  • General cognitive functioning 1
  • Memory 1
  • Executive functioning 1

Subjective vs. Objective Memory Changes

• A significant majority (81%) of pregnant women report subjective memory impairment 4
• This subjective perception aligns with objective findings in everyday memory tasks but may not be detected in all laboratory tests 2
• The discrepancy between subjective complaints and some objective measures may be due to:
  • Testing environments not capturing real-world memory demands 2
  • Different types of memory being affected differently (recall vs. recognition) 3

Contributing Factors to Pregnancy-Related Memory Changes

• Physical symptoms of pregnancy contribute to both objective and subjective memory deficits 2
• Depressed mood during pregnancy can exacerbate subjective memory complaints 2
• Sleep disruption is a significant predictor of reported memory changes, though not necessarily of objective performance 5
• The pattern of memory loss during pregnancy differs from other amnesic conditions, suggesting unique mechanisms 4

Clinical Implications

• Information provided to pregnant patients may not be retained as well as expected, particularly when presented in formats requiring active recall 4
• Healthcare providers should consider using recognition-based memory aids (checklists, written instructions) rather than relying on recall-based verbal instructions 3
• Memory changes appear to be temporary and related to pregnancy itself rather than permanent cognitive decline 5
• The specific pattern of memory changes (impaired recall with preserved recognition) suggests a shift in cognitive processing strategy rather than global cognitive impairment 3

Long-Term Outlook

• Most memory changes appear to resolve in the postpartum period 3
• These temporary changes are consistent with findings of pregnancy-related reductions in brain gray matter volume 1
• Pregnant women can generally be reassured that while memory changes are real, they are typically temporary and do not represent a decline in overall cognitive capability 5