Sleep, physical activity, and pregnancy symptoms: Factors associated with cognitive performance in early pregnancy

Virginia R Nuckols; Kristen G Davis; Gary L Pierce; Karin F Hoth; Mark K Santillan; Bethany Barone Gibbs; Kara M Whitaker

doi:10.1016/j.midw.2025.104585

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Sleep, physical activity, and pregnancy symptoms: Factors associated with cognitive performance in early pregnancy

Journal article

Peer reviewed

Sleep, physical activity, and pregnancy symptoms: Factors associated with cognitive performance in early pregnancy

Virginia R Nuckols, Kristen G Davis, Gary L Pierce, Karin F Hoth, Mark K Santillan, Bethany Barone Gibbs and Kara M Whitaker

Midwifery, Vol.150, 104585

11/2025

DOI: 10.1016/j.midw.2025.104585

PMCID: PMC12771380

PMID: 40907119

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Abstract

Women often report disruptions in cognitive performance during pregnancy. Though substantiated by objective assessments, findings have been inconsistent and potential contributing factors are not well understood. The objective of this study was to examine the cross-sectional associations between maternal mood, stress, pregnancy-related symptoms and device measured 24-hour activity behaviors with cognitive performance in the first trimester of pregnancy. Pregnant women (N=90) were assessed in the first trimester. Non-pregnant controls (N=73) were assessed 1-5 years after pregnancy. Depressive symptoms, (Center for Epidemiological Studies Depression Scale), stress (Perceived Stress Scale), and pregnancy-specific health related quality of life (Nausea and Vomiting during Pregnancy Health-Related Quality of Life) were evaluated using validated questionnaires, and 24-hour activity measured via actigraphy (activPAL, Actiwatch Spectrum Plus). Cognitive performance was evaluated using tests of memory, processing speed, and executive function. Pregnant women performed lower on memory tests compared with non-pregnant women. Neither depressive symptoms nor stress were associated with lower cognitive performance in pregnancy. Physical symptoms of pregnancy (e.g., nausea, vomiting) were related to lower memory scores (β=0.32, P=0.02). Longer sleep duration was associated with better executive function performance (β=1.4, P=0.03). This study demonstrates lower memory performance in the first trimester of pregnancy compared with non-pregnant controls and indicates that pregnancy symptoms and shorter sleep duration may be contributing factors.

Executive function

Sleep

Pregnancy symptoms

Physical activity

Memory

Details

Title: Subtitle: Sleep, physical activity, and pregnancy symptoms: Factors associated with cognitive performance in early pregnancy
Creators: Virginia R Nuckols - University of Iowa
Kristen G Davis - University of Iowa
Gary L Pierce - University of Iowa
Karin F Hoth - University of Iowa
Mark K Santillan - University of Iowa
Bethany Barone Gibbs - West Virginia University
Kara M Whitaker - University of Iowa
Resource Type: Journal article
Publication Details: Midwifery, Vol.150, 104585
DOI: 10.1016/j.midw.2025.104585
PMID: 40907119
PMCID: PMC12771380
NLM abbreviation: Midwifery
ISSN: 0266-6138
eISSN: 1532-3099
Publisher: Elsevier
Grant note: National Institutes of Health: R01-HL153095 American Heart Association: 22TPA969732, HD089940-01A1, P50HD103556, 18SCG34350001
This study was primarily supported by National Institutes of Health grants R01-HL153095 to KMW and American Heart Association grants 22TPA969732 to GLP and HD089940-01A1, P50HD103556, and 18SCG34350001 to MKS. The funders played no role in study design, collection/analysis/interpretation of data, manuscript preparation and editing, or in the decision to submit this manuscript.
Language: English
Electronic publication date: 08/28/2025
Date published: 11/2025
Academic Unit: Psychiatry; Epidemiology; Iowa Neuroscience Institute; Obstetrics and Gynecology; Health, Sport, and Human Physiology ; Internal Medicine
Record Identifier: 9984958609202771

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