The effects of perinatal depression and anxiety on memory, attention, and cognitive flexibility: a systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis examined whether perinatal depressive and anxiety symptoms are associated with memory, attention, and cognitive flexibility. It included 42 studies of women during pregnancy and postpartum. Depressive symptoms were consistently associated with self-reported cognitive complaints across six studies, but findings from objective cognitive tasks were inconsistent. Verbal and recognition memory were not associated with depressive or anxiety symptoms; evidence concerning autobiographical memory was limited. The authors conclude that perceived cognitive difficulties are linked to depressive symptoms, while evidence for objective cognitive impairment remains inconclusive.

Key findings

• Across six studies, depressive symptoms were significantly positively associated with self-reported cognitive complaints.
• Objective-task findings were inconsistent for working memory (k = 11), attention (k = 24), and cognitive flexibility (k = 5).
• Verbal memory (k = 8) and recognition memory (k = 2) were not associated with depressive or anxiety symptoms.
• Autobiographical memory was associated with depressive symptoms, but evidence came from only three studies.

Why it matters

The distinction between subjective complaints and objective test performance cautions against assuming that perceived cognitive difficulties indicate measurable impairment. Mood may be relevant to how cognitive function is experienced during the perinatal period, but the available evidence does not establish the nature or mechanisms of this relationship. Better longitudinal and ecologically valid research could clarify these findings.

What to keep in mind

Most studies were cross-sectional, used self-reported symptom measures and heterogeneous, non-ecological cognitive tasks, and rarely assessed anxiety, limiting the strength and generalizability of conclusions.