Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa; Azienda Ospedaliera Universitaria Pisana (AUOP), Pisa, Italy.
Obstetrics and Gynaecology, Department of Medical Area (DAME), University of Udine, Udine, Italy.
J Sleep Res. 2024 Dec;33(6):e14202. doi: 10.1111/jsr.14202. Epub 2024 Mar 24.
While insomnia symptoms may be a risk factor for mental disturbances, few studies evaluated "Insomnia Disorder" and its relationship with perinatal psychopathology. Pregnant women were recruited during their last routine assessment before being hospitalized for delivery during the 3rd trimester at the Gynaecological Unit of the University Hospital of Ferrara and Udine, Italy, from January 2022 to January 2023. Our assessment included baseline evaluation (T0), and evaluations at 1 month (T1) and 3 months (T2) in the postpartum period, with specific questionnaires for insomnia disorder, such as Sleep Condition Indicator, mood and anxiety symptoms and psychosocial functioning, such as Edinburgh Postnatal Depression Scale, Mood Disorder Questionnaire, State-Trait Anxiety Inventory, Work and Social Adjustment Scale. At T0, 181 pregnant women were included. Insomnia disorder affected 22.3% at T0, 23.5% at T1 and 16.2% at T2. Women with insomnia disorder at baseline were significantly more affected by concurrent anxiety and depressive symptoms, had higher bipolar diathesis and poorer psychosocial functioning in the perinatal period. Prenatal insomnia disorder predicted anxiety (T0: odds ratio 4.44, p << 0.001; T1: odds ratio 4.009, p = 0.042) and depressive symptoms (T0: odds ratio 2.66, p = 0.015; T1: odds ratio 11.20, p = 0.001; T2: odds ratio 12.50 p = 0.049) in both the prenatal and postnatal period. It also predicted poor psychosocial function during the prenatal (odds ratio 3.55, p = 0.003) and postpartum periods (T1: odds ratio 2.33, p = 0.004). Insomnia disorder is emerging as an important prenatal factor that may contribute to concurrent and postpartum psychopathology.
虽然失眠症状可能是精神障碍的一个风险因素，但很少有研究评估“失眠障碍”及其与围产期精神病理学的关系。本研究于 2022 年 1 月至 2023 年 1 月期间在意大利费拉拉和乌迪内大学医院的妇科病房，在孕妇住院分娩前的最后一次常规评估时招募了她们。我们的评估包括基线评估（T0），以及产后 1 个月（T1）和 3 个月（T2）的评估，使用专门的失眠障碍问卷，如睡眠状况指标、情绪和焦虑症状以及社会心理功能，如爱丁堡产后抑郁量表、心境障碍问卷、状态-特质焦虑量表。在 T0 时，共纳入 181 名孕妇。失眠障碍在 T0 时影响 22.3%，T1 时影响 23.5%，T2 时影响 16.2%。基线时患有失眠障碍的女性在围产期同时受到焦虑和抑郁症状的影响更明显，双相障碍倾向更高，社会心理功能更差。产前失眠障碍预测产前和产后焦虑（T0：优势比 4.44，p<<0.001；T1：优势比 4.009，p=0.042）和抑郁症状（T0：优势比 2.66，p=0.015；T1：优势比 11.20，p=0.001；T2：优势比 12.50，p=0.049）。它还预测了产前（优势比 3.55，p=0.003）和产后（T1：优势比 2.33，p=0.004）期间较差的社会心理功能。失眠障碍作为一个重要的产前因素出现，可能导致同时发生的产后精神病理学。
