318. CHANGES IN DECISION MAKING BEHAVIOR BETWEEN PREGNANCY AND POSTPARTUM

Abstract Background Pregnancy causes major physiological changes that are thought to impact decision making and reward processing. It is poorly understood if these alterations remain or change in the postpartum period. Aims & Objectives We aim to characterize decision making with repeated measures in pregnancy and postpartum periods using a validated cognitive gambling task and one of the largest sample sizes to date. Method Participants completed the Gambling Task in the Cambridge Neuropsychological Test Automated Battery (CANTAB) in the third trimester of pregnancy and three months post-partum (N=101). Quality of decision making, delay aversion, risk adjustment and risk taking scores from the CANTAB gambling task were compared between pregnancy and postpartum using a two-way repeated measures ANOVA with Tukey HSD post-hoc analysis. Results Risk taking, the mean proportion of gambled points, was significantly higher (F(1, 99)=48.732, p < 0.0001) in the postpartum period (M=0.60, SE=0.02) compared to pregnancy (M=0.52, SE=0.02). Risk adjustment, or risk taking while accounting for new information, was significantly lower (F(1, 99)=3.977, p=0.049) in postpartum period (M=1.35, SE=0.11) compared to pregnancy (M=1.55, SE=0.11). Differences in decision making and delay aversion were not statistically significant. Discussion & Conclusions Higher risk taking and lower risk adjustment in the postpartum period suggests there may be changes in risk decision making behavior between pregnancy and postpartum. One explanation for these findings is that they may be influenced by heightened impulsivity and diminished cognitive flexibility during the postpartum period. These results are clinically relevant because they suggest a potential shift in cognitive or emotional states, which could inform healthcare providers in tailoring support and interventions to address decision-making behaviors and promote maternal well-being during this critical period.