The Third Xiangya Hospital of Central South University, Department of Nursing, Changsha, Hunan, China.
Xiangya Nursing School, Central South University, Changsha, Hunan, China.
J Affect Disord. 2023 Apr 14;327:38-45. doi: 10.1016/j.jad.2023.01.125. Epub 2023 Feb 3.
Perinatal depression is a global mental health problem. Studies have suggested that perinatal depression is related to poor sleep quality during pregnancy. However, evidence on the influence and mechanism of sleep quality on the risk of developing perinatal depression remains limited and inconclusive.
A systematic review was conducted in PubMed, Web of Science, Embase, CINAHI and Cochrane Library for relevant original quantitative studies published in English. A hand search of the reference list of relevant studies was also performed. Meta-analysis was performed using RevMan software and a random-effects model. Potential heterogeneity source was explored by subgroup and sensitivity analyses, and potential publication bias was tested using funnel plots and Begg's test.
A total of ten studies involving 39,574 participants were included in our meta-analysis. Overall, women who experienced poor sleep quality during pregnancy were at a significantly higher risk of developing depression, with antenatal depression 3.72 times higher, postpartum depression 2.71 times higher, and perinatal depression 3.46 times higher, compared to those did not experience poor sleep quality.
Different measuring tools and unobserved confounding factors may make some bias in our result. What's more, not all included studies were initially designed to assess the association between antenatal sleep quality and the risk of developing perinatal depression.
Our meta-analysis found that antenatal sleep quality was negatively associated with the risk for perinatal depression. Our findings highlight the importance of improving sleep quality during pregnancy for mental health among perinatal women.
围产期抑郁症是一个全球性的心理健康问题。研究表明,围产期抑郁症与妊娠期间睡眠质量差有关。然而,关于睡眠质量对围产期抑郁症发病风险的影响和机制的证据仍然有限且不一致。
我们在 PubMed、Web of Science、Embase、CINAHI 和 Cochrane Library 中对发表于英文期刊的相关原始定量研究进行了系统评价。还对手头相关研究的参考文献进行了手工搜索。使用 RevMan 软件和随机效应模型进行荟萃分析。通过亚组和敏感性分析探索潜在的异质性来源,并使用漏斗图和 Begg 检验测试潜在的发表偏倚。
共有 10 项研究,涉及 39574 名参与者,纳入了我们的荟萃分析。总体而言,与没有经历睡眠质量差的孕妇相比,经历妊娠期间睡眠质量差的孕妇患抑郁症的风险明显更高,产前抑郁症的风险高 3.72 倍,产后抑郁症的风险高 2.71 倍,围产期抑郁症的风险高 3.46 倍。
不同的测量工具和未观察到的混杂因素可能会使我们的结果产生一些偏差。更重要的是,并非所有纳入的研究最初都是为了评估产前睡眠质量与围产期抑郁症发病风险之间的关联而设计的。
我们的荟萃分析发现,产前睡眠质量与围产期抑郁症的发病风险呈负相关。我们的研究结果强调了改善妊娠期间睡眠质量对围产期妇女心理健康的重要性。