Sleep disorders during pregnancy and postpartum depression: A systematic review and meta‐analysis

Maghami, Mahboobeh; Shariatpanahi, Seyyed Payam; Habibi, Danial; Heidari‐Beni, Motahar; Badihian, Negin; Hosseini, Mohsen; Kelishadi, Roya

doi:10.1002/jdn.10118

Cited by 26 publications

(20 citation statements)

References 37 publications

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“…Results of the present study were not in line with findings suggesting that poor sleep in pregnancy is associated with post-partum depression ( 33 ). This may be explained by the fact that studies on post-partum depression have carried out their sleep assessments in late pregnancy or post-partum, whereas women participating in the present study recorded their sleep patterns during the first half of pregnancy.…”

Section: Discussioncontrasting

confidence: 99%

“…Based on objective measurements, the findings of this study confirm prior findings of women's subjective reporting of sleep disturbances and their risk of developing depressive symptoms during pregnancy ( 30 , 31 , 33 ). Thus, this study has added important value to the subjective reports of women by establishing that poor sleep, in this case objectively evaluated by actigraphy, may contribute to an increased risk of depression during pregnancy.…”

Section: Discussionsupporting

confidence: 85%

“…It should be pointed out that the majority of studies investigating sleep and perinatal depression have relied on subjective sleep assessments (using self-report questionnaires) and largely focused on sleep assessments in the third trimester and the post-partum period ( 19 , 33 , 34 ). However, the use of self-report may be problematic due to discrepancies between subjective and objective sleep measurements ( 22 , 35 ), especially in patients with depression, who tend to over-report sleep problems ( 36 , 37 ).…”

Section: Introductionmentioning

confidence: 99%

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Association Between Objectively Assessed Sleep and Depressive Symptoms During Pregnancy and Post-partum

Pitsillos

Wikström

Skalkidou

et al. 2022

Front. Glob. Womens Health

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IntroductionSleep problems are common in pregnancy but many studies have relied only on self-reported sleep measures. We studied the association between objectively measured sleep and peripartum depressive symptoms in pregnant women.Material and MethodsSleep was assessed using Actiwatch accelerometers in a sample of 163 pregnant women in the late first (weeks 11–15) or early second trimester (weeks 16–19). Depressive symptoms were assessed in gestational weeks 17, 32 and at 6 weeks post-partum using the Edinburgh Postnatal Depression Scale (EPDS). Multiple linear regression and logistic regression analyses, adjusting for age, BMI, pre-pregnancy smoking, ongoing mental health problems, trimester and season of sleep assessment were carried out to test the association between sleep and depression. Sleep was measured by total sleep time and sleep efficiency, whereas depression was indicated by depressive symptoms and depression caseness. Results are presented as unstandardized beta (B) coefficients or adjusted odds ratios (AOR) and 95% confidence intervals (CI).ResultsTotal sleep time ranged from 3 to 9 h (mean 7.1, SD 0.9) and average sleep efficiency was 83% (SD 6.0). Women with the shortest total sleep time, i.e., in the lowest quartile (<6.66 h), reported higher depressive symptoms during pregnancy (week 17, B = 2.13, 95% CI 0.30–3.96; week 32, B = 1.70, 95% CI 0.03–3.37) but not post-partum. Their probability to screen positive for depression in gestational week 17 was increased more than 3-fold (AOR = 3.46, 95% CI 1.07–11.51) but unchanged with regards to gestational week 32 or 6 weeks post-partum. Sleep efficiency was not associated with depressive symptoms at any stage of pregnancy or post-partum.DiscussionIn one of the few studies to use objective sleep measures to date, mental health of pregnant women appeared to be affected by shortened sleep, with total sleep time being negatively associated with depressive symptoms in the early second and third trimester. This finding highlights the relevance of identifying and treating sleep impairments in pregnant women early during antenatal care to reduce the risk of concomitant depression.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Association Between Objectively Assessed Sleep and Depressive Symptoms During Pregnancy and Post-partum

Pitsillos

Wikström

Skalkidou

et al. 2022

Front. Glob. Womens Health

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“…We do not know if the 14 women who left the study before follow‐up may have developed a depression, but as shown in Dataset S1, they suffered more from sleep disturbances in pregnancy, which is a known risk factor for depression. 22 , 80 Further, we have no information on the longitudinal changes in 5‐HIAA and EPDS, for ethical and practical reasons. However, by studying these phenomena in healthy women, we may have unmasked associations that would have been obscured by other risk factors for PND.…”

Section: Discussionmentioning

confidence: 99%

The role of central serotonergic markers and estradiol changes in perinatal mental health

Borgsted

Høgh

Høgsted

et al. 2022

Acta Psychiatr Scand

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Objective: Women have an increased risk for mental distress and depressive symptoms in relation to pregnancy and birth. The serotonin transporter (SERT) may be involved in the emergence of depressive symptoms postpartum and during other sex-hormone transitions. It may be associated with cerebrospinal fluid (CSF) levels of the main serotonin metabolite 5-hydroxyindolacetic acid (5-HIAA). In 100 healthy pregnant women, who were scheduled to deliver by cesarean section (C-section), we evaluated 5-HIAA and estradiol contributions to mental distress 5 weeks postpartum.Methods: Eighty-two women completed the study. CSF collected at C-section was analyzed for 5-HIAA, with high performance liquid chromatography.Serum estradiol concentrations were quantified by liquid chromatography tandem mass spectrometry before C-section and postpartum. Postpartum mental distress was evaluated with the Edinburgh Postnatal Depression Scale (EPDS).Associations between EPDS, 5-HIAA, and Δestradiol were evaluated in linear regression models adjusted for age, parity and SERT genotype.

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“…Significant sleep disturbance is not only common, but also adverse for health 9 , 10 . Multitudinous studies have researched the relationship between sleep during pregnancy and subsequent maternal and fetal outcomes 11 , 12 . However, some previous studies reported that sleep had no association with adverse pregnancy outcomes, whereas other emerging evidence suggested that sleep was involved in adverse maternal complications and fetal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Maternal sleep during pregnancy and adverse pregnancy outcomes: A systematic review and meta‐analysis

Wang

Yang

et al. 2022

J of Diabetes Invest

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Aims/Introduction Sleep problems are important public health concern worldwide. We carried out a meta‐analysis to quantitatively evaluate whether sleep duration was associated with pregnancy outcomes, and the associations were modified by important characteristics of studies. Materials and Methods Based on PubMed, Embase and the Cochrane Central Register of Controlled Trials databases, we searched for published literature related to maternal sleep duration and adverse pregnancy outcomes before 30 June 2021. We carried out risk of bias assessment, subgroup analyses and sensitivity analysis. The relative risks or odds ratios with 95% confidence intervals (CI) were used to estimate the pooled effects. Results A total of 5,246 references were identified through a database search, and 41 studies were included in the study. Pregnant women with short sleep duration had 1.81‐fold (95% CI 1.35–2.44, P < 0.001) the risk of developing gestational diabetes mellitus. The association between short sleep duration and the risk of gestational hypertension, cesarean section, low birthweight, preterm birth and small for gestational age were not significant ( P > 0.05). Furthermore, long sleep duration was significantly correlated with gestational diabetes mellitus (odds ratio1.24. 95% CI 1.12–1.36, P < 0.001) and CS (odds ratio 1.13. 95% CI 1.04–1.22, P = 0.004), whereas long sleep duration was not linked with gestational hypertension, low birthweight, preterm birth and small for gestational age ( P > 0.05). Conclusions Short/long sleep duration appeared to be associated with adverse pregnancy outcomes, specifically with an increased risk of gestational diabetes mellitus. Sleep should be systematically screened in the obstetric population.

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Sleep disorders during pregnancy and postpartum depression: A systematic review and meta‐analysis

Cited by 26 publications

References 37 publications

Association Between Objectively Assessed Sleep and Depressive Symptoms During Pregnancy and Post-partum

Association Between Objectively Assessed Sleep and Depressive Symptoms During Pregnancy and Post-partum

The role of central serotonergic markers and estradiol changes in perinatal mental health

Maternal sleep during pregnancy and adverse pregnancy outcomes: A systematic review and meta‐analysis

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