During pregnancy, cognitive function may decline due to changes in brain physiology, and psychological changes can lead to fear of childbirth (1). Regular physical activity helps support metabolic, physiological, and psychological health. This is the first study to explores the relationship between physical activity, cognitive function, and fear of childbirth during pregnancy (2,3). This study aims to investigate the relationship between physical activity level, cognitive function and birth fear during pregnancy. By revealing these relationships, we aim to develop practices to improve these parameters and to guide clinicians working in the field of women's health to include interventions to improve these parameters in pregnancy education programs. We hypothesized that there is a significant relationship between physical activity level, cognitive function and birth fear in pregnant women.

Pregnant women between the ages of 18-40 years and between 8-37 weeks of gestational age who routinely applied to the gynecology and obstetrics outpatient clinic were included in this study. Exclusion criteria were being left handed, gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), presence of eclampsia or pre-eclampsia, presence of neurologic disease, presence of severe cardiovascular disease and severe systemic disorders. An assessment form was used to record the participant’s demographic, physical and medical information such as age, height, weight, educational status, employment status. The Pregnancy Physical Activity Questionnaire (PPAQ), Montreal Cognitive Assessment (MoCA), and Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Version A was used to assess the level of physical activity, cognitive function, and birth fear. Statistical analyses were performed using the SPSS program (version 27). Descriptive statistics were presented as mean ± standard deviation and number (percentage). Pearson correlation test was used to examine the relationship between physical activity level, cognitive function and fear of childbirth. Statistical significance level was accepted as p<0.05.

One hundred sixty pregnant women  were invited to participate of this study and fourteen women were excluded from the study because they were being left handed, GDM, PIH, and neurologic disease. The mean of age and body mass index (BMI) of individuals participating in this study were 28.29 ± 5.11 years and 28.62±5.02 kg/m2 . Among the pregnant women, 54 (37%) had undergraduate or postgraduate education, while 92 (63%) had an education level below undergraduate. The total activity score of PPAQ was 42.12±20.62 MET–h.week-1. The scores obtained from the MoCA total and its subdomains (visuospatial/executive, naming, attention, language, abstraction, memory, and orientation) were, 18.93±4.15, 2.97±0.76, 2.42±0.76, 2.94±1.61, 1.52±0.99, 0.86±0.78, 2.41±1.37, 5.79±0.46, respectively. MoCA scores were ≤25 in 139 pregnant women (93.9%). In addition, the total score of W-DEQ was 47.73±23.09. A weak negative correlation was found between PPAQ-household/caregiving and MoCA-attention and total scores (p1=0.010, r1=-0.212; p2=0.039, r2=-0.171), while a weak positive correlation was observed between PPAQ-occupational and MoCA-visuospatial/executive, attention, and total scores (p3=0.013, r3=0.206; p4=0.001, r4= 0.271; p5=0.001, r5=0.279). In addition, a weak positive correlation was found between PPAQ-sport/exercise and MoCA-memory (p6=0.006, r6=0.229). No significant relationship was found between the other parameters (p>0.05).

The results show that as household/caregiving activity increases, cognitive function attention and total scores decrease. As occupational activity increases, cognitive function's visuospatial/executive, attention, and total scores also increase. In addition, the results show that the memory sub-dimension of cognitive function increases as sports/exercise activities increase.

The study findings suggest that different types of physical activity may have different effects on cognitive function during pregnancy. Encouraging pregnant women to engage in structured physical activities and planning training programs may support their cognitive health. Given the weak correlations observed, further research is needed to investigate the underlying mechanisms and other possible factors.

Haines, H., & Rubertsson, C. (2012). The influence of women’s fear, attitudes and beliefs of childbirth on mode and experience of birth. BMC Pregnancy and Childbirth, 12, 55. https://doi.org/10.1186/1471-2393-12-55
Çiçek, Ö., & Mete, S. (2015). A common problem: Fear of childbirth. DEUHYO E-Journal, 8(4), 263-268.
Melzer, K., Schutz, Y., Boulvain, M., & Kayser, B. (2010). Physical activity and pregnancy. Sports Medicine, 40(6), 493-507. https://doi.org/10.2165/11532290-000000000-00000