Characterizing Literacy and Cognitive Function during Pregnancy and Postpartum.
ObjectiveThe objective of this study was to characterize health literacy and cognitive function in a diverse cohort of pregnant women.MethodsPregnant and postpartum women underwent in-depth assessments of health literacy/numeracy and the cognitive domains of verbal ability, working memory, long-term memory, processing speed, and inductive reasoning. Differences by demographic characteristics and gestational age were assessed using chi-square tests and multivariable logistic regression.ResultsIn this cohort of pregnant (N= 77) or postpartum (N= 24) women, 41.6% had limited health literacy/numeracy. Women were more likely to score in the lowest quartile for literacy and verbal ability if they were less educated, younger, nonwhite or had Medicaid. These factors were associated with low scores for long-term memory, processing speed, and inductive reasoning. Although there were no differences in literacy or cognitive function by parity or gestational age, postpartum women were more likely to score in the lowest quartile for processing speed (adjusted odds ratio [aOR]: 3.79, 95% confidence interval [CI]: 1.32-10.93) and inductive reasoning (aOR: 4.07, 95% CI: 1.21-13.70).ConclusionAlthough postpartum status was associated with reduced inductive reasoning and processing speed, there were no differences in cognitive function across pregnancy.Practice ImplicationsPostpartum maternal learning may require enhanced support. In addition, cognitive skills and health literacy may be a mediator of perinatal outcomes inequities.
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Lynn M
LM
Yee
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Leslie A
LA
Kamel
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Zara
Z
Quader
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Priya V
PV
Rajan
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Shaneah M
SM
Taylor
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Rachel
R
O'Conor
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.|Department of Learning Sciences, Northwestern University, Evanston, Illinois.
Michael S
MS
Wolf
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.|Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.|Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Melissa A
MA
Simon
D000046:Academic Medical Centers; D000328:Adult; D002641:Chicago; D003071:Cognition; D015331:Cohort Studies; D005260:Female; D057220:Health Literacy; D006801:Humans; D016015:Logistic Models; D008568:Memory; D015999:Multivariate Analysis; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy / Q000523:psychology*; D011295:Prenatal Care; D011795:Surveys and Questionnaires; D055815:Young Adult