Characterizing Literacy and Cognitive Function during Pregnancy and Postpartum

Objective The objective of this study was to characterize health literacy and cognitive function in a diverse cohort of pregnant women. Methods Pregnant 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. Results In 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). Conclusion Although postpartum status was associated with reduced inductive reasoning and processing speed, there were no differences in cognitive function across pregnancy. Practice Implications Postpartum maternal learning may require enhanced support. In addition, cognitive skills and health literacy may be a mediator of perinatal outcomes inequities.