Haavisto Henna, Rinne Kirsi, Kolari Terhi, Anttila Ella, Ojala Elina, Polo-Kantola Päivi
Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland.
Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland.
Eur J Obstet Gynecol Reprod Biol. 2023 Apr;283:25-31. doi: 10.1016/j.ejogrb.2023.01.028. Epub 2023 Jan 25.
Depressive symptoms and sleep disturbances have been found to be associated with negative labor experiences, particularly an increased level of pain. However, the associations between maternal depressive symptoms and sleep disturbances and the experience of induction of labor (IOL) remain unknown. In this study, we evaluated these associations with balloon catheter IOL.
A prospective study was conducted on 106 women with planned IOL. Depressive symptoms were evaluated with The Edinburg Postnatal Depression Scale (EPDS) and sleep disturbances with the Basic Nordic Sleep Questionnaire (BNSQ) at the beginning of IOL. The IOL experience was investigated both during the IOL and postpartum with the same nine visual analogue scale (VAS) questions.
Regarding sleep disturbances, during the IOL, women with worse general sleep quality were less satisfied (P = 0.019), less relaxed (P = 0.008), experienced more pain in general (P = 0.002) and reported higher contraction frequency (P = 0.003). Furthermore, women who experienced difficulties falling asleep were less relaxed (P = 0.009), reported more general pain (P < 0.001) and contraction pain (P = 0.005), while those with more daytime sleepiness reported less contraction pain (P = 0.033). In postpartum, women with worse general sleep quality reported more general pain (P = 0.003), while women with longer sleep duration and those with higher sleep loss reported more anxiety (P = 0.009 and P = 0.024, respectively). Additionally, women who woke up too early in the morning were less satisfied (P = 0.042), less relaxed (P = 0.004) and reported more general pain (P = 0.018). However, those who experienced more frequent nocturnal awakenings reported being more relaxed (P = 0.014) and having less general pain (P = 0.033). Higher depressive symptoms were associated with a higher frequency of contractions during IOL (P = 0.030), but with less general pain in postpartum (P = 0.027).
Women with sleep disturbances during pregnancy were more likely to report more negative experiences during the IOL. Specifically, they reported more pain, feeling less relaxed and they were less satisfied with IOL. Conversely, the association between depressive symptoms and the experience of IOL seemed weaker. Thus, the quality of sleep of pregnant women is important for a better experience of IOL.
抑郁症状和睡眠障碍已被发现与不良分娩经历相关，尤其是疼痛程度增加。然而，产妇抑郁症状和睡眠障碍与引产经历之间的关联仍不明确。在本研究中，我们评估了这些与球囊导管引产之间的关联。
对106名计划进行引产的女性进行了一项前瞻性研究。在引产开始时，使用爱丁堡产后抑郁量表（EPDS）评估抑郁症状，使用北欧基本睡眠问卷（BNSQ）评估睡眠障碍。在引产期间和产后，使用相同的九个视觉模拟量表（VAS）问题调查引产经历。
关于睡眠障碍，在引产期间，总体睡眠质量较差的女性满意度较低（P = 0.019），放松程度较低（P = 0.008），总体疼痛更多（P = 0.002），且宫缩频率更高（P = 0.003）。此外，入睡困难的女性放松程度较低（P = 0.009），总体疼痛更多（P < 0.001），宫缩疼痛更多（P = 0.005），而白天嗜睡较多的女性宫缩疼痛较少（P = 0.033）。在产后，总体睡眠质量较差的女性总体疼痛更多（P = 0.003），而睡眠时间较长和睡眠缺失较多的女性焦虑更多（分别为P = 0.009和P = 0.024）。此外，早上醒来过早的女性满意度较低（P = 0.042），放松程度较低（P = 0.004），总体疼痛更多（P = 0.018）。然而，夜间醒来更频繁的女性报告说更放松（P = 0.014），总体疼痛更少（P = 0.033）。较高的抑郁症状与引产期间较高的宫缩频率相关（P = 0.030），但与产后总体疼痛较少相关（P = 0.027）。
孕期有睡眠障碍的女性在引产期间更有可能报告更多负面经历。具体而言，她们报告疼痛更多，感觉更不放松，对引产的满意度更低。相反，抑郁症状与引产经历之间的关联似乎较弱。因此，孕妇的睡眠质量对于获得更好的引产体验很重要。
