Endorsement of a single-item measure of sleep disturbance during pregnancy and risk for postpartum depression: a retrospective cohort study.
Endorsement of a single-item measure of sleep disturbance during pregnancy and risk for postpartum depression: a retrospective cohort study.
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DOI：
10.1007/s00737-022-01287-9
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发表时间：
2023-02
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产前睡眠质量差与抑郁症状的风险增加有关，但在短暂、忙碌的产前护理中可能没有被发现。在非抑郁孕妇中，我们评估了1)抑郁问卷上对睡眠障碍的认可是否预示着产后抑郁症状，2)这些联系的强度高于怀孕和抑郁的其他躯体症状(即疲劳、食欲障碍)，以及3)对产前睡眠障碍的认可因参与者的特征而异。在这项回溯性队列研究中，参与者在2012年至2017年期间进行了活产，并完成了怀孕期间和产后8周内的患者健康问卷(PHQ-9)。研究对象为孕期无抑郁的受试者(PHQ-9&Lt；10)(n=3619)。我们将睡眠障碍、疲劳和食欲障碍分别作为PHQ-9的第3、4和5项的认可，将产后抑郁症状作为≥10的PHQ-9总分的认可。参与者的特征变量包括年龄、种族、民族、产次、分娩时胎龄和早产。产前睡眠障碍与产后抑郁症状的发生有关(AORS 1.9，95%CI 1.2~3.1；中期3.7，95%CI 1.5~11.5；晚期妊娠3.4，95%CI 1.9~6.8)。妊娠早期和晚期的疲乏和食欲障碍与产后抑郁症状的几率较高相关。在怀孕的第一和第二个三个月，睡眠障碍因种族而异(p<；0.05)，在黑人或非裔美国人参与者中最高(61.8-65.1%)。常规实施的睡眠障碍单项测量可以确定其他风险较低的孕妇，他们可能从预防抑郁症的努力中受益。网上版载有补充材料，可在10.1007/s00737-022-01287-9查阅。
Poor prenatal sleep quality is associated with increased risk for depressive symptoms but may go undetected in brief, busy prenatal care visits. Among non-depressed pregnant participants, we evaluated whether 1) the endorsement of sleep disturbance on a depression questionnaire predicted postpartum depressive symptoms, 2) the strength of these associations was higher than other somatic symptoms of pregnancy and depression (i.e., fatigue, appetite disturbance), and 3) the endorsement of prenatal sleep disturbance varied by participant characteristics. In this retrospective cohort study, participants had a live birth and completed Patient Health Questionnaire (PHQ-9) during pregnancy and within 8 weeks postpartum between 2012 and 2017. Participants who were non-depressed during pregnancy (PHQ-9 < 10) were included (n = 3619). We operationalized sleep disturbance, fatigue, and appetite disturbance as endorsement of item 3, 4, and 5 on the PHQ-9, respectively, and postpartum depressive symptoms as PHQ-9 total score ≥ 10. Participant characteristic variables included age, race, ethnicity, parity, gestational age at delivery, and preterm birth. Prenatal sleep disturbance was associated with higher odds of postpartum depressive symptoms (aORs 1.9, 95% CI 1.2–3.1 for first trimester; 3.7, 95% CI 1.5–11.5 for second trimester; 3.4, 95% CI 1.9–6.8 for third trimester). Fatigue and appetite disturbance in the first and third trimesters were associated with higher odds of postpartum depressive symptoms. Sleep disturbance varied by race during the first and second trimesters (p < 0.05) and was highest among Black or African American participants (61.8–65.1%). A routinely administered single-item measure of sleep disturbance could identify otherwise lower-risk pregnant individuals who may benefit from depression prevention efforts. The online version contains supplementary material available at 10.1007/s00737-022-01287-9.
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