Variations of the cognitive status in the puerperium and their determinants: a narrative review

Abstract The neurobiological modifications that women experience during the puerperium, together with the consequent psychosocial changes, lead to variations in cognitive functions. In order to describe the cognitive variations that occur during postpartum and the determining factors, a narrative review was conducted by means of a bibliographic search in PubMed and Google Scholar. A steady increase in the number of published works was located (PubMed = 186; Google Scholar = 26,730). The analysis of the articles made it possible to: a) characterize the cognitive functions during the puerperium; b) analyze the neuropsychological effects produced by the endocrinological and anatomophysiological changes; c) analyze the effect of the quality of sleep on cognition; d) analyze cognitive functions according to obstetric experiences. In conclusion, puerperal women are characterized by variations in their cognitive functions, which are determined by structural, functional, psychological and social changes. It is necessary to conduct neuropsychological research in this population, since postpartum care still focuses on the care of the newborn, without addressing the puerperal woman in a comprehensive manner.

摘要
女性在产褥期所经历的神经生物学改变，加之随之而来的社会心理变化，会引发认知功能的波动。为阐明产后阶段出现的认知变化及其影响因素，本研究通过在PubMed及Google Scholar数据库中开展文献检索，完成了一项叙述性综述。检索结果显示相关发表文献的数量呈稳步增长趋势（PubMed收录186篇，Google Scholar收录26730篇）。通过对纳入文献的分析，本综述实现了以下目标：a）阐明产褥期的认知功能特征；b）分析内分泌与解剖生理变化所产生的神经心理学效应；c）探讨睡眠质量对认知功能的影响；d）结合产科分娩经历分析认知功能的变化情况。综上，产褥期女性的认知功能存在波动，该波动由结构、功能、心理及社会层面的多重变化共同决定。当前产后护理仍以新生儿照料为核心，未对产褥期女性开展全面照护，因此针对该人群开展神经心理学研究具有重要意义。