Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis
Abstract Background Poor sleep quality and maternal mood disturbances are common during pregnancy and may play pivotal roles in the development of postpartum depression. We aim to examine the trajectories of sleep quality and mental health in women from early pregnancy to delivery and explore the me...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-022-04164-y |
| _version_ | 1798038043934851072 |
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| author | Yu Wang Han Liu Chen Zhang Cheng Li Jing-Jing Xu Chen-Chi Duan Lei Chen Zhi-Wei Liu Li Jin Xian-Hua Lin Chen-Jie Zhang Han-Qiu Zhang Jia-Le Yu Tao Li Cindy-Lee Dennis Hong Li Yan-Ting Wu |
| author_facet | Yu Wang Han Liu Chen Zhang Cheng Li Jing-Jing Xu Chen-Chi Duan Lei Chen Zhi-Wei Liu Li Jin Xian-Hua Lin Chen-Jie Zhang Han-Qiu Zhang Jia-Le Yu Tao Li Cindy-Lee Dennis Hong Li Yan-Ting Wu |
| author_sort | Yu Wang |
| collection | DOAJ |
| description | Abstract Background Poor sleep quality and maternal mood disturbances are common during pregnancy and may play pivotal roles in the development of postpartum depression. We aim to examine the trajectories of sleep quality and mental health in women from early pregnancy to delivery and explore the mediating effects of sleep quality and mental status on the link between antepartum depressive symptoms and postpartum depressive symptoms. Methods In an ongoing prospective birth cohort, 1301 women completed questionnaires in the first, second and third trimesters and at 6 weeks postpartum. In each trimester, sleep quality was measured utilizing the Pittsburgh Sleep Quality Index (PSQI), and mental health was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), the Self-Rating Anxiety Scale (SAS) and the Perceived Stress Scale (PSS). Postpartum depressive symptoms were evaluated by the Edinburgh Postnatal Depression Scale (EPDS). The bootstrap method was used to test the mediation effect. Results The PSQI, CES-D, and SAS scores presented U-shaped curves across the antenatal period while the PSS score followed a descending trend. Antenatal sleep quality, depressive symptoms, anxiety symptoms and perceived stress all predicted depressive symptoms at 6 weeks postpartum. The influence of antepartum depressive symptoms on postpartum depressive symptoms was mediated by antepartum sleep quality and anxiety symptoms, which accounted for 32.14%, 39.25% and 31.25% in the first, second and third trimesters (P = 0.002, P = 0.001, P = 0.001, respectively). Conclusions Poor sleep quality and anxiety symptoms in pregnancy mediated the relationship between antepartum depressive symptoms and postpartum depressive symptoms. Interventions aimed at detecting and managing sleep quality and elevated anxiety among depressed women in pregnancy warrant further investigation as preventative strategies for postpartum depression. |
| first_indexed | 2024-04-11T21:34:50Z |
| format | Article |
| id | doaj.art-49fb060efe5d43f49f723aa5c0983538 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-11T21:34:50Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-49fb060efe5d43f49f723aa5c09835382022-12-22T04:01:48ZengBMCBMC Psychiatry1471-244X2022-08-0122111110.1186/s12888-022-04164-yAntepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysisYu Wang0Han Liu1Chen Zhang2Cheng Li3Jing-Jing Xu4Chen-Chi Duan5Lei Chen6Zhi-Wei Liu7Li Jin8Xian-Hua Lin9Chen-Jie Zhang10Han-Qiu Zhang11Jia-Le Yu12Tao Li13Cindy-Lee Dennis14Hong Li15Yan-Ting Wu16School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversityObstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversityObstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan UniversityObstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversityBloomberg Faculty of Nursing, University of TorontoSchool of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong UniversityObstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan UniversityAbstract Background Poor sleep quality and maternal mood disturbances are common during pregnancy and may play pivotal roles in the development of postpartum depression. We aim to examine the trajectories of sleep quality and mental health in women from early pregnancy to delivery and explore the mediating effects of sleep quality and mental status on the link between antepartum depressive symptoms and postpartum depressive symptoms. Methods In an ongoing prospective birth cohort, 1301 women completed questionnaires in the first, second and third trimesters and at 6 weeks postpartum. In each trimester, sleep quality was measured utilizing the Pittsburgh Sleep Quality Index (PSQI), and mental health was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), the Self-Rating Anxiety Scale (SAS) and the Perceived Stress Scale (PSS). Postpartum depressive symptoms were evaluated by the Edinburgh Postnatal Depression Scale (EPDS). The bootstrap method was used to test the mediation effect. Results The PSQI, CES-D, and SAS scores presented U-shaped curves across the antenatal period while the PSS score followed a descending trend. Antenatal sleep quality, depressive symptoms, anxiety symptoms and perceived stress all predicted depressive symptoms at 6 weeks postpartum. The influence of antepartum depressive symptoms on postpartum depressive symptoms was mediated by antepartum sleep quality and anxiety symptoms, which accounted for 32.14%, 39.25% and 31.25% in the first, second and third trimesters (P = 0.002, P = 0.001, P = 0.001, respectively). Conclusions Poor sleep quality and anxiety symptoms in pregnancy mediated the relationship between antepartum depressive symptoms and postpartum depressive symptoms. Interventions aimed at detecting and managing sleep quality and elevated anxiety among depressed women in pregnancy warrant further investigation as preventative strategies for postpartum depression.https://doi.org/10.1186/s12888-022-04164-ySleep qualityMental statusPerinatal depressive symptomsMediating effect |
| spellingShingle | Yu Wang Han Liu Chen Zhang Cheng Li Jing-Jing Xu Chen-Chi Duan Lei Chen Zhi-Wei Liu Li Jin Xian-Hua Lin Chen-Jie Zhang Han-Qiu Zhang Jia-Le Yu Tao Li Cindy-Lee Dennis Hong Li Yan-Ting Wu Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis BMC Psychiatry Sleep quality Mental status Perinatal depressive symptoms Mediating effect |
| title | Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis |
| title_full | Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis |
| title_fullStr | Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis |
| title_full_unstemmed | Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis |
| title_short | Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis |
| title_sort | antepartum sleep quality mental status and postpartum depressive symptoms a mediation analysis |
| topic | Sleep quality Mental status Perinatal depressive symptoms Mediating effect |
| url | https://doi.org/10.1186/s12888-022-04164-y |
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