(116) Poor sleep quality in pregnancy is associated adverse mental health outcomes through 12 months postpartum

Prenatal insomnia affects >40% of women in the 3rd trimester. We sought to quantify the association of insomnia symptoms with postpartum mental health and stress.


Study Design:

We analyzed data from the Mood, Mother, and Infant Study cohort study. Psychiatric history was assessed at enrollment in the 3^rd trimester via Structured Clinical Interview, with oversampling of women with a history or current diagnosis of major depressive disorder or anxiety disorders. Sleep quality was assessed with the Pittsburgh Sleep Quality Index at baseline and at 2, 6 and 12 months. Poor sleep was defined by threshold score of >5. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) monthly and the Everyday Stress Index and Parenting Stress Index at 2, 6 and 12 months postpartum. We used repeated measures analysis to measure the association of these outcomes with Poor Sleep in Pregnancy (PSP), adjusting for psychiatric history. We used linear regression to compare 12-month postpartum measures among women whose poor sleep resolved postpartum, defined as all postpartum PSQI ≤5, compared with those with persistent poor sleep, defined as at least one postpartum PSQI > 5, adjusting for psychiatric history. P values < 0.05 were considered statistically significant.


Results:
Among 221 participants, 106 (48.0%) had PSP. PSP was associated with worse sleep quality postpartum (p< .0001), higher EPDS scores (p< .0001), higher parenting stress (p< .0001), and higher everyday stress (p=.0003). At 12 months, compared with persistent poor sleep, resolution of poor sleep following delivery was associated with improved EPDS scores (5.7 vs. 2.6, p< .01) . Differences in parenting stress (72.8 vs. 67.7, p=.16) and everyday stress (13.4 vs 10.2, p=.12) among those with resolved versus persistent poor sleep were not statistically significant.

Conclusion:

PSP is associated with poor postpartum sleep, perinatal depression symptoms, and stress. Resolution of poor sleep is associated with improved mood one year after birth. Treatment of PSP is a promising strategy to improve maternal mental health.