Sleep Disturbances and Depressive and Anxiety Symptoms During Pregnancy: Associations With Delivery and Newborn Health

Abstract

Background: Sleep disturbances and mood symptoms are common in late pregnancy and according to previous literature, they can affect delivery and newborn outcomes. This study evaluated the effect of sleep and mood symptoms on delivery and newborn health as there is insufficient and partly contradictory studies on the topic.Methods: A cohort of 1414 mothers was enrolled in the third trimester to this prospective cross-sectional questionnaire study. Validated questionnaires were assessed for measurement of sleep disturbances, depressive and anxiety symptoms. The data on delivery and newborn outcomes was obtained from hospital medical records.Results. Sleep disturbances were very common during pregnancy. Higher insomnia score (β = -0.06, p = 0.047) and longer sleep need (β = 0.07, p = 0.047) were related to delivery at a lower gestational age. In addition, higher insomnia score (β = -28.30, p = 0.010) and lower general sleep quality (β = -62.15, p = 0.025) were associated with lower birth weight, but instead, longer sleep duration and longer sleep need with higher birth weight (β = 28.06, p = 0.019; β = 27.61, p = 0.028, respectively). However, the findings regarding birth weight lost their significance when the birth weight was standardized with gestational weeks. Concerning Apgar scores and the umbilical artery pH, no associations were found. Snoring was associated with a shorter duration of the 1st phase (β = -78.71, p = 0.015) and total duration of delivery (β = -79.85, p = 0.016). Mothers with higher insomnia, depressive or anxiety symptoms were more often treated with oxytocin (OR 1.54 95% CI 1.00-2.38, p = 0.049, OR 1.76, 95% CI 1.02-3.04, p = 0.049 and OR 1.91, CI 95% 1.28-2.84, p < 0.001, respectively) and those with higher depressive and anxiety symptoms delivered more often with elective caesarean section (OR 4.67, 95% CI 2.04-12.68, p < 0.001 and OR 2.22, 95% CI 1.03-4.79, p = 0.042).Conclusions: Maternal sleep disturbances and mood symptoms during pregnancy are associated with delivery and newborn health. However, nearly all the outcomes fell within a normal range, implying that the actual risks are low.