Prevalence of Poor Sleep Quality in Perinatal and Postnatal Women: A Comprehensive Meta-Analysis of Observational Studies

Yang, Yuan; Li, Wen; Ma, Tiangang; Zhang, Ling; Hall, Brian J.; Ungvári, Gábor S.; Xiang, Yu‐Tao

doi:10.3389/fpsyt.2020.00161

Cited by 81 publications

(68 citation statements)

References 70 publications

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“…The heterogeneity of outcomes were assessed using I 2 , with I 2 > 50% as significant heterogeneity ( Higgins et al, 2003 ). Following the recommendation of the Cochrane handbook ( Higgins et al, 2019 ) and other studies ( Li et al, 2020 ; Xu et al, 2020 ; Yang et al, 2020 ), publication bias was assessed using the funnel plots and Begg’s test and Tweedie’s trim-and-fill analysis. All data analyses were 2 tailed, and the significant level was set at 0.05.…”

Section: Methodsmentioning

confidence: 99%

Older adults at high risk of HIV infection in China: a systematic review and meta-analysis of observational studies

Wang

Yang

Chen

et al. 2020

PeerJ

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There is an increasing prevalence of human immunodeficiency virus (HIV) infection in older adults in China, but the findings across prevalence studies have been mixed. This is the first meta-analysis of the prevalence of HIV infection and its moderating factors in older adults in China. Two investigators systematically and independently searched both international (PubMed, PsycINFO, Web of Sciences and EMBASE) and Chinese (WanFang, CNKI, and CQVIP) databases. HIV infection rates in older adults were analyzed using the random-effects model. Altogether 46 studies were included in the analysis. The pooled prevalence of HIV infection in older adults was 2.1% (95% CI [1.9%–2.3%], I2 = 99.4%). Subgroup analyses revealed that men who have sex with men (MSM), hospital population samples, publications after 2014, studies conducted in the western region of China, and higher study quality were significantly associated with higher HIV infection rate. This meta-analysis found that the HIV infection prevalence in older adults is significantly higher than the general population in China. Attention should be given to this urgent public health issue, and effective HIV/AIDS preventive, screening and treatment measures are warranted in this population. PROSPERO: CRD42019124286.

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Section: Methodsmentioning

confidence: 99%

Older adults at high risk of HIV infection in China: a systematic review and meta-analysis of observational studies

Wang

Yang

Chen

et al. 2020

PeerJ

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“…This theory is primarily based on three lines of reasoning. The first is that sleep loss is both a symptom and frequently cited precipitant of mania unrelated to childbirth [73], while second, acute sleep disruption occurs almost universally in women during the immediate postpartum [74]. Third, neurotransmitters such as dopamine and serotonin are well evidenced to play a role in mood disorders, the systems of which may interact and overlap to also regulate circadian rhythms, including those relating to the sleep/wake cycle and hormone secretion [75,76].…”

Section: Sleep Deprivation/circadian Rhythm Disruptionmentioning

confidence: 99%

Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review

et al. 2021

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Postpartum psychoses are a severe form of postnatal mood disorders, affecting 1–2 in every 1000 deliveries. These episodes typically present as acute mania or depression with psychosis within the first few weeks of childbirth, which, as life-threatening psychiatric emergencies, can have a significant adverse impact on the mother, baby and wider family. The nosological status of postpartum psychosis remains contentious; however, evidence indicates most episodes to be manifestations of bipolar disorder and a vulnerability to a puerperal trigger. While childbirth appears to be a potent trigger of severe mood disorders, the precise mechanisms by which postpartum psychosis occurs are poorly understood. This review examines the current evidence with respect to potential aetiology and childbirth-related triggers of postpartum psychosis. Findings to date have implicated neurobiological factors, such as hormones, immunological dysregulation, circadian rhythm disruption and genetics, to be important in the pathogenesis of this disorder. Prediction models, informed by prospective cohort studies of high-risk women, are required to identify those at greatest risk of postpartum psychosis.

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“…There are documented decrements in sleep quality after childbirth; postpartum maternal sleep is characterized by fragmented sleep from waking to feed and tend to infants at night which in turn lowers sleep e ciency (the percentage of time spent in actual sleep) and reduces sleep duration [18][19][20]. In a meta-analysis of 28 studies, Yang et al [21] found that the prevalence of poor sleep quality for women during the postpartum period was 67.2% (95% CI [57.6-75.5%]). In the context of poor postpartum sleep quality, Wilson, Lee, and Bei [22] indicated that up to 60% of women experience elevated fatigue.…”

Section: Introductionmentioning

confidence: 99%

Mad, Sad, or Sleepy? Relationships between Postpartum Maternal Anger, Depression, and Sleep: A Cross-Sectional Survey Study

Hall

Rodney

et al. 2021

Preprint

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Background: Although some women experience anger as a mood problem after childbirth, postpartum anger has been neglected by researchers. Poor maternal and infant sleep quality during the postpartum period has been associated with depressive symptoms; however, links between sleep quality and postpartum anger are unclear. This study aimed to determine the proportions of women with significant anger, depressive symptoms, and comorbid anger and depressive symptoms, and to examine maternal and infant sleep quality as correlates of postpartum anger. Methods: This cross-sectional survey study was advertised as an examination of mothers’ and babies’ sleep. Women, with healthy infants between 6 and 12 months of age, were recruited using social media. The survey contained validated measures of maternal and infant sleep quality, and maternal fatigue, social support, anger, depressive symptoms, and cognitions about infant sleep. Results: 278 women participated in the study. Thirty-one percent of women (n = 85) reported high anger levels (≥ 90th percentile on State Anger Scale) while 26% (n = 73) of mothers indicated probable depression (>12 on Edinburgh Postnatal Depression Scale). Women reported a mean of 6.2 hours of sleep (SD = 1.2 hours, range = 4 – 9 hours); over half of the participants rated their sleep as poor (n = 144, 51.8 %). Using robust regression analysis, income (b = -0.74, p < 0.05), parity (b = 2.05, p < 0.01), depressive symptoms (b = 0.59, p < 0.01), maternal sleep quality (b = 0.98, p < 0.05), and maternal anger about infant sleep (b = 0.50, p < 0.01) were significant predictors of maternal anger. Conclusions: Maternal sleep quality and anger about infant sleep are associated with maternal state anger. Clinicians should educate families about sleep pattern changes during the perinatal time frame and assess women’s mood and perceptions of maternal and infant sleep quality in the first postpartum year. They can also offer evidence-based strategies for improving parent-infant sleep. Such health promotion initiatives could reduce maternal anger and support healthy maternal-infant sleep.

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Prevalence of Poor Sleep Quality in Perinatal and Postnatal Women: A Comprehensive Meta-Analysis of Observational Studies

Cited by 81 publications

References 70 publications

Older adults at high risk of HIV infection in China: a systematic review and meta-analysis of observational studies

Older adults at high risk of HIV infection in China: a systematic review and meta-analysis of observational studies

Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review

Mad, Sad, or Sleepy? Relationships between Postpartum Maternal Anger, Depression, and Sleep: A Cross-Sectional Survey Study

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