Prenatal maternal sleep and trajectories of postpartum depression and anxiety symptoms
Prenatal maternal sleep and trajectories of postpartum depression and anxiety symptoms
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DOI：
10.1111/jsr.13258
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发表时间：
2020-12-15
影响因子：
4.4
通讯作者：
Tikotzky, Liat
中科院分区：
文献类型：
--
作者：
Gueron-Sela, Noa;Shahar, Golan;Tikotzky, Liat
产后情绪困扰非常常见，10%-20%的产后女性患有抑郁或焦虑症。睡眠是情绪困扰的一个可改变的危险因素，在产后调整中发挥着关键作用。本研究旨在探讨怀孕期间的睡眠持续时间和质量是否可以预测产后情绪困扰的轨迹。参与者为 215 名女性，从妊娠晚期到产后 18 个月接受评估。在所有五个时间点（妊娠晚期、产后 3 个月、6 个月、12 个月和 18 个月），睡眠持续时间和质量的测量（通过入睡后的觉醒时间测量；WASO）均来自体动记录仪和基于日记的测量。使用自我报告措施收集抑郁和焦虑症状的重复测量结果。结果显示了四种双变量产后抑郁和焦虑的增长轨迹，包括（a）高合并症（5.4%）； (b) 中度合并症（19.4%）； (c) 焦虑程度低，抑郁症状减少（18.6%）； (d) 低症状（56.6%）。多项逻辑回归分析显示，与低症状类别相比，怀孕期间睡眠时间较短的母亲更有可能属于高合并症或中度症状类别。此外，与低症状类别相比，产后 3 个月 WASO（即睡眠质量较低）较高的母亲更有可能属于中度类别。考虑到围产期睡眠中断的潜在负面影响，本研究可能为未来针对怀孕期间睡眠问题的干预研究提供信息。
Postpartum emotional distress is very common, with 10%-20% of postpartum women reporting depressive or anxiety disorders. Sleep is a modifiable risk factor for emotional distress that has a pivotal role in postpartum adjustment. The present study aimed to examine whether sleep duration and quality during pregnancy predict trajectories of emotional distress in the postpartum period. Participants were 215 women that were assessed from the third trimester of pregnancy to 18-months postpartum. At all five time points (third trimester, 3-, 6-, 12-, and 18-months postpartum), measures of sleep duration and quality (measured by wake time after sleep onset; WASO) were derived from both actiography and diary-based measures. Repeated measures of depression and anxiety symptoms were collected using self-report measures. Results indicated four bivariate postpartum depression and anxiety growth trajectories, including (a) high comorbidity (5.4%); (b) moderate comorbidity (19.4%); (c) low anxiety and decreasing depression symptomology (18.6%); and (d) low symptomology (56.6%). Multinomial logistic regression analyses showed that mothers with shorter sleep durations during pregnancy were more likely to belong to the high comorbidity or moderate symptoms classes compared to the low symptomology class. In addition, mothers with higher WASO (i.e. lower sleep quality) at 3-months postpartum were more likely to belong to the moderate class compared to the low symptomology class. Given the potential negative implications of disrupted sleep in the perinatal period, the present study may inform future intervention studies that target sleep problems during pregnancy.