Gynecology & Obstetrics
Open Access

Abstract

Identifying Prospective Biomarkers for Cognitive Impairments during Pregnancy - Review of Current Status and Some Preliminary Results

M. S. Nagananda, Amit Sengupta, S. M. K. Rehman, J. Santhosh and S. Anand

Pregnancy, childbirth, and early motherhood physiologically and psychologically affect a woman’s cognitive parameters. Hormonal alterations during early pregnancy, enlargement of the fetus during late pregnancy, and newborn with random sleep-wake patterns all contribute to cognitive parameters. Cognitive impairments are frequent in pregnancy and it is coupled with a range of undesirable outcomes, including maternal death. Recent studies indicate that pregnant women with cognitive impairment, mild to severe, are at increased risk for spontaneous abortion, preterm labor and for having a growth-retarded baby. The majority of older studies are cross-sectional designs, with comparisons to age-matched healthy controls. Many studies suffer from small sample sizes, lack statistical power for consistent interpretation and replication of findings about cognitive impairments during pregnancy. More recent studies are longitudinal designs to describe changes in cognitive parameters during the course of pregnancy. However, women’s baseline, pre pregnancy, psychiatric, neurological, and genetically inherited parameters are not considered. With very few published reports of cognitive complexities during pregnancy, it is very difficult to understand the implications of altered cognitive parameters patterns on postpartum period and women’s health outcomes. In prenatal period, a woman is in frequent contact with health professionals and it provides an opportunity to predict and prevent pregnancy complications. Early identification, appropriate referral to a specialist for pregnancy complications is key requirements to manage pregnancy outcome successfully. This requires the coordinated participation of professionals in primary care, maternity services and mental health services to work closely with women and their families. The purpose of this study is to review the current status of research being done in this nescient area and propose prospective biomarkers for cognitive impairments during pregnancy with reference to psychiatric parameters during pregnancy. The comprehensive model of accepted interrelationships between psycho - physiological, subjective, and objective assessment methodologies are presented. We identified a need for developing potential diagnostic instruments to screen pregnancy complications with more objective based methods and we present here some of the preliminary results of our work that has been done in this nascent area.