Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China.
Vanke School of Public Health, Tsinghua University, Beijing 100084, China.
J Affect Disord. 2023 Apr 14;327:292-298. doi: 10.1016/j.jad.2023.01.127. Epub 2023 Feb 7.
Previous literature has shown a significant association between sleep and depression, whereas limited studies have examined the association of sleep quality with self-harm ideation in pregnant Chinese women.
A total of 898 pregnant women (first to third trimester) from the Young Investigation Study were enrolled in this study. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Antepartum depression and self-harm ideation were evaluated using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs).
In this sample, the prevalence of poor sleep quality and antepartum depression was 44.3 % and 24.4 %, respectively. Furthermore, 12.8 % of women were considered as having self-harm ideation. Individuals in different trimesters reported similar prevalence of self-harm thoughts. Women were more likely to report self-harm thoughts if they were categorized as poor sleep quality or antepartum depression. And women with moderate or severe depression had higher risk of self-harm ideation and poor sleep, compared with those with mild depression. Although sleep quality indirectly influenced self-harm thoughts through the mediation effect of depressive symptoms, poor sleep quality was still associated with a 2.62-fold increased odds of self-harm ideation among women in the second trimester (OR = 2.62; 95 % CI: 1.11-6.21), after adjustment for depression.
Causality cannot be inferred. Results should be generalized carefully. Depression was evaluated by a screening tool rather than clinical interviews.
The prevalence of poor sleep quality, depressive symptoms and self-harm ideation in pregnant Chinese women were noteworthy and high. Besides, a direct effect was also found between sleep quality and self-harm thoughts among women in the second trimester. Our findings suggest the need to identify and intervene when sleep disturbances are observed in women during pregnancy.
先前的文献表明睡眠与抑郁之间存在显著关联，而有限的研究则探讨了睡眠质量与中国孕妇自残意念之间的关系。
这项研究共纳入了来自 Young Investigation Study 的 898 名（孕 1 至 3 期）孕妇。采用匹兹堡睡眠质量指数（PSQI）问卷评估睡眠质量。采用爱丁堡产后抑郁量表（EPDS）评估产前抑郁和自残意念。采用多变量逻辑回归模型计算比值比（OR）和 95%置信区间（CI）。
在该样本中，睡眠质量差和产前抑郁的发生率分别为 44.3%和 24.4%。此外，有 12.8%的女性被认为存在自残意念。处于不同孕期的女性报告的自残意念发生率相似。如果女性被归类为睡眠质量差或产前抑郁，她们更有可能报告自残意念。与轻度抑郁的女性相比，中度或重度抑郁的女性自残意念和睡眠质量差的风险更高。尽管睡眠质量通过抑郁症状的中介效应间接影响自残意念，但在调整抑郁因素后，处于孕中期的女性睡眠质量差与自残意念的发生风险仍增加 2.62 倍（OR=2.62；95%CI：1.11-6.21）。
不能推断因果关系。结果应谨慎推广。抑郁是通过筛查工具而非临床访谈评估的。
中国孕妇睡眠质量差、抑郁症状和自残意念的发生率较高。此外，还发现处于孕中期的女性睡眠质量与自残意念之间存在直接关系。我们的研究结果表明，有必要在孕妇出现睡眠障碍时进行识别和干预。
