Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Childrenges Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai, China.
Sleep. 2018 Dec 1;41(12). doi: 10.1093/sleep/zsy179.
To examine trajectories of poor sleep quality from late pregnancy to 36 months postpartum, baseline indicators, and association with prospective maternal mood disturbances.
A cohort of 262 nonclinical women was followed at late pregnancy, 42 days, 3, 6, 9, 12, 18, 24, and 36 months postpartum. Sleep quality was measured with the Pittsburgh Sleep Quality Index at all time points, and mood disturbances were assessed at late pregnancy and 36 months postpartum.
The rate of poor sleep quality followed an inverted U-shaped curve. Women reporting poor sleep quality at late pregnancy held a consistently higher risk of poor sleep quality at postpartum points. Three sleep trajectories were distinguished, namely, the stable-low (29.4%), the decreasing-mild (56.5%), and the stable-high (14.1%). Poor sleep quality, depression, and anxiety at baseline were linked to trajectory groups with poorer sleep quality. Adjusting for covariates, the trajectory of the poorer sleep quality group demonstrated increased mood disturbances at 36 months postpartum. Replicating the analyses in women without baseline symptoms of depression and anxiety above clinical cutoffs obtained similar results.
Women are vulnerable to poor sleep quality from late pregnancy to postpartum years, but follow distinct trajectories. Poor sleep quality, depression, and anxiety at late pregnancy help us to anticipate the sleep trajectories. Trajectories of poor sleep quality indicate increased mood disturbances at 36 months postpartum. A flexible suite of interventions targeting both poor sleep quality and mood disturbances should be implemented and tailored to women in the prenatal and postpartum periods.
探讨从妊娠晚期到产后 36 个月期间睡眠质量不良的轨迹、基线指标及其与前瞻性产妇情绪障碍的关系。
对 262 名非临床女性进行了队列研究，随访时间为妊娠晚期、产后 42 天、3、6、9、12、18、24 和 36 个月。所有时间点均采用匹兹堡睡眠质量指数（PSQI）测量睡眠质量，妊娠晚期和产后 36 个月评估情绪障碍。
睡眠质量不良的发生率呈倒 U 型曲线。妊娠晚期报告睡眠质量不良的女性在产后各时点睡眠质量不良的风险持续较高。区分出三种睡眠轨迹，即稳定低（29.4%）、下降轻（56.5%）和稳定高（14.1%）。基线时的睡眠质量不良、抑郁和焦虑与睡眠质量较差的轨迹组有关。调整协变量后，较差睡眠质量组在产后 36 个月时表现出情绪障碍增加。在基线时没有抑郁和焦虑症状超过临床截止值的女性中重复分析，得到了类似的结果。
女性从妊娠晚期到产后多年都容易出现睡眠质量不良，但存在不同的轨迹。妊娠晚期的睡眠质量不良、抑郁和焦虑有助于预测睡眠轨迹。较差的睡眠质量轨迹预示着产后 36 个月时情绪障碍增加。针对睡眠质量不良和情绪障碍的灵活干预措施套件应在产前和产后期间实施，并针对女性进行定制。
