Department of Obstetrics and Gynecology, CHA Ilsan Medical Center, CHA University, Goyang, Republic of Korea.
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea.
Int J Gynaecol Obstet. 2021 Oct;155(1):125-131. doi: 10.1002/ijgo.13602. Epub 2021 Feb 12.
To determine the association between insufficient sleep in the prenatal period and postpartum depression (PPD), and whether changes in sleep patterns during pregnancy increase the risk of PPD.
A prospective cohort study was conducted between March 2013 and November 2017. Participants completed a sleep questionnaire pre-pregnancy and at 12, 24 and 36 gestational weeks (GW). Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale (EPDS) at 4 weeks postpartum, and the cut-off score for PPD was 10 or more.
Of 2512 participants, 410 (16.3%) were identified as having PPD. Only insufficient sleep at 36 GW was significantly associated with PPD after adjusting for confounding factors (odds ratio 1.79, 95% confidence interval 1.40-2.27, P < 0.001). Both Group 1 (change from sufficient to insufficient) and Group 3 (sustained insufficient) demonstrated a significant risk of PPD at all starting time-points in the multivariate analysis, but no significant association was evident between Group 2 (change from insufficient to sufficient) and PPD.
Insufficient sleep at 36 GW was associated with a significant risk of developing PPD. Additionally, regardless of whether women had sufficient sleep, a shift towards worsening sleep at 36 GW was highly associated with PPD.
确定孕期睡眠不足与产后抑郁症（PPD）之间的关联，以及孕期睡眠模式的变化是否会增加 PPD 的风险。
这是一项前瞻性队列研究，于 2013 年 3 月至 2017 年 11 月进行。参与者在妊娠前和 12、24 和 36 孕周（GW）时完成了睡眠问卷。在产后 4 周时使用爱丁堡产后抑郁量表（EPDS）评估抑郁症状，PPD 的截断值为 10 或更高。
在 2512 名参与者中，有 410 名（16.3%）被确定为患有 PPD。仅在调整混杂因素后，36 GW 的睡眠不足与 PPD 显著相关（优势比 1.79，95%置信区间 1.40-2.27，P<0.001）。在多变量分析中，第 1 组（从不充足到充足的变化）和第 3 组（持续不足）在所有起始时间点均显示出 PPD 的显著风险，但第 2 组（从不充足到充足的变化）与 PPD 之间没有明显关联。
36 GW 的睡眠不足与发生 PPD 的风险显著相关。此外，无论女性的睡眠是否充足，36 GW 时睡眠恶化的转变与 PPD 高度相关。
