Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis.
Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis.
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产前睡眠质量、精神状态与产后抑郁症状：一项中介效应分析
DOI：
10.1186/s12888-022-04164-y
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发表时间：
2022-08-02
期刊：
影响因子：
4.4
通讯作者：
Wu, Yan-Ting
中科院分区：
文献类型：
--
作者：
Wang, Yu;Liu, Han;Zhang, Chen;Li, Cheng;Xu, Jing-Jing;Duan, Chen-Chi;Chen, Lei;Liu, Zhi-Wei;Jin, Li;Lin, Xian-Hua;Zhang, Chen-Jie;Zhang, Han-Qiu;Yu, Jia-Le;Li, Tao;Dennis, Cindy-Lee;Li, Hong;Wu, Yan-Ting
孕期睡眠质量差和产妇情绪紊乱较为常见，可能在产后抑郁症的发生发展中起着关键作用。我们旨在研究女性从孕早期到分娩期间睡眠质量和心理健康的变化轨迹，并探究睡眠质量和心理状态在产前抑郁症状与产后抑郁症状之间关联中的中介作用。
在一项正在进行的前瞻性出生队列研究中，1301名女性在孕早期、中期、晚期以及产后6周完成了问卷调查。在每个孕期阶段，睡眠质量采用匹兹堡睡眠质量指数（PSQI）进行评估，心理健康状况则通过流调中心抑郁量表（CES-D）、自评焦虑量表（SAS）以及感知压力量表（PSS）进行评定。产后抑郁症状采用爱丁堡产后抑郁量表（EPDS）进行评估。采用Bootstrap法检验中介效应。
PSQI、CES-D和SAS得分在整个孕期呈U型曲线，而PSS得分呈下降趋势。产前睡眠质量、抑郁症状、焦虑症状和感知压力均能预测产后6周的抑郁症状。产前抑郁症状对产后抑郁症状的影响通过产前睡眠质量和焦虑症状起中介作用，在孕早期、中期、晚期，中介效应分别占32.14%、39.25%和31.25%（P值分别为0.002、0.001、0.001）。
孕期睡眠质量差和焦虑症状在产前抑郁症状与产后抑郁症状之间起中介作用。针对孕期抑郁女性开展旨在检测和改善睡眠质量、缓解焦虑情绪的干预措施，作为预防产后抑郁症的策略，值得进一步研究。
本文网络版包含补充材料，链接：10.1186/s12888-022-04164-y 。
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. 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. 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). 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. The online version contains supplementary material available at 10.1186/s12888-022-04164-y.
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