Affective and cognitive empathy in pregnant women and nulligravid controls: a multidimensional neuroendocrine evaluation.

Pregnancy is accompanied by profound neuroendocrine adaptations that prepare the maternal brain for caregiving and social responsiveness. Although empathy represents a key component of maternal behavior, it remains unclear whether pregnancy is associated with distinct patterns of emotional and cognitive empathy and how these patterns relate to neuroendocrine factors. This cross-sectional study included 111 women (68 pregnant and 43 nulligravid controls). Empathy was assessed using the Interpersonal Reactivity Index, with separate evaluation of emotional and cognitive components. Salivary oxytocin and serum testosterone levels were measured using ELISA. The second-to-fourth digit ratio (2D:4D) was assessed as an indirect marker of prenatal androgen exposure. Pregnant participants exhibited higher emotional empathy and lower cognitive empathy than controls, whereas total empathy scores did not differ between groups. Emotional empathy differed across pregnancy trimesters and was highest in the second trimester. Pregnant women also showed higher salivary oxytocin and lower serum testosterone levels (p < 0.05). Oxytocin levels were positively correlated with empathy measures in the control group but not in pregnant women. No significant correlations were observed between the 2D:4D ratio and empathy measures. Pregnancy was characterized by a distinct pattern of affective and cognitive empathy within a complex neuroendocrine milieu. These findings support the view that empathic processing during pregnancy should be considered a multidimensional phenomenon shaped by coordinated neuroendocrine influences rather than the action of a single hormone. A better understanding of these neuroendocrine mechanisms may contribute to future research on maternal socio-emotional functioning and maternal mental health.