Executive functioning in matrescence and implications for perinatal depression

Ghadimi, T. Roxana; McCormack, Clare · 2025 · DOAJ

DOI: 10.3389/fpsyt.2025.1663017

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Summary

This review paper investigates the relationship between executive functioning (EF), neuroplasticity during matrescence (the transition to motherhood), and perinatal depression. Motivated by the high prevalence of perinatal mood and anxiety disorders and the urgent need for effective interventions, the authors examine how cognitive changes during pregnancy and postpartum may influence maternal mental health. The paper specifically addresses the gap in understanding normative EF changes versus pathological deficits, aiming to clarify how the "mental load of motherhood" interacts with cognitive capacity to potentially exacerbate vulnerability to depression. The authors conducted a comprehensive review of existing literature, synthesizing findings from neuroimaging studies, neuropsychological assessments, and qualitative research. They analyzed evidence regarding structural and functional brain changes in primiparous women, comparing perinatal cognitive performance against non-pregnant controls. The review also integrated data on EF impairments in major depressive disorder (MDD) to extrapolate potential mechanisms in perinatal depression. Key areas of focus included the impact of the home environment on cognitive testing, the role of emotion regulation in caregiving, and the emerging concept of the mental load of motherhood as a unique stressor. The review finds that matrescence involves significant, adaptive neuroplasticity, characterized by reductions in gray matter volume in prefrontal regions associated with the Default Mode and Frontoparietal Networks. While 50–80% of pregnant women report subjective cognitive difficulties ("mommy brain"), objective neuropsychological tests reveal only small, transient deficits in EF domains such as working memory and cognitive inhibition, particularly in the third trimester. These normative changes are distinct from the more pronounced EF impairments seen in MDD, which involve altered activity in prefrontal executive networks. In perinatal depression, studies indicate specific deficits in working memory and cognitive inhibition, which may impair a mother’s ability to manage caregiving demands and regulate emotions. The authors highlight that the mental load of motherhood—encompassing invisible cognitive and emotional labor—places significant demands on EF, potentially overwhelming cognitive resources and contributing to mental health vulnerabilities. The significance of this work lies in its call to integrate cognitive, neurobiological, and psychosocial factors into maternal mental health research. The authors conclude that distinguishing normative adaptive plasticity from pathological EF deficits is crucial for accurate diagnosis and intervention. They emphasize that the mental load of motherhood is a critical, yet under-measured, factor in maternal well-being. Future research should focus on longitudinal studies with consistent methodologies to clarify the progression of cognitive changes and develop validated instruments for measuring mental load. Understanding these dynamics is essential for creating interventions that support parental well-being and address the complex interplay between cognition, emotion, and the demands of modern parenting.

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• executive function