Sleep Moderates and Mediates the Relationship Between Acculturation and Depressive Symptoms in Pregnant Mexican-American Women

Abstract

Purpose Greater acculturation is associated with adverse perinatal outcomes in Mexican-American women, but the mechanisms by which acculturation influences perinatal outcomes are unclear. Pregnant acculturated Mexican-American women are more likely to engage in unhealthy prenatal behaviors relative to those less acculturated, including poor sleep. As sleep disruptions are associated with acculturation and negative perinatal outcomes, particularly maternal depression, alterations in sleep may adversely affect pregnant Mexican-American women. Methods Sixty pregnant women of Mexican descent completed surveys about sleep, acculturation, depressive symptoms and potential protective factor of social support. Results Acculturation, but not social support, significantly predicted increased sleep disruptions as well as overall feeling less refreshed upon waking across pregnancy. Moderation analysis indicated that more acculturated women who took longer to fall asleep reported increased depressive symptoms. Feeling refreshed upon waking also mediated the relationship between increased acculturation and elevated maternal depressive symptoms. Conclusions Acculturation and altered sleep contribute to greater risk in Mexican-American women for maternal depressive symptoms in the perinatal period. These findings have implications for prevention and treatment of maternal mental health disorders, which may adversely affect perinatal outcomes in the vulnerable Mexican-American population.

Depressive symptoms and sleep disturbances in Korean American women

“…Acculturation was not related to sleep disturbances and this finding is different from previous study findings among Mexican Americans, where acculturation was related to sleep disturbances (D'Anna- Hernandez et al, 2016;Heilemann et al, 2012). This difference may be connected with the use of different measurement tools and/or the different ethnic groups sampled in these studies.…”

“…Meanwhile, Hielemann et al (2012) used age immigrated to the U.S. as an indication of acculturation and D'Anna- Hernandez et al (2016) used the Acculturation Scale for Hispanics (Marin, Sabogal, Marin, Otero-Sabogal, & Perez-Stable, 1987), which assesses media, language use, and ethnic social relations as unidimensional acculturation. Measures used to assess sleep disturbances were also different; while previous studies used the General Sleep Disturbance Scale (Heilemann et al, 2012;Lee, 1992) and selfreport Sleep Diaries (D'Anna- Hernandez et al, 2016), the current study used the Pittsburgh Sleep Quality Index (Buysse et al, 1989). These different research instruments may have elicited slightly different aspects of sleep quality resulting in the different findings.…”

“…Women who migrated to the U.S. at age of 17 years and younger were more likely to report sleep disturbances than those who came as an adult (Heilemann et al, 2012). Among pregnant Mexican American women, both acculturation and altered sleep were linked to depressive symptoms (D'Anna- Hernandez, Garcia, Coussons-Read, Laudenslager, & Ross, 2016). A high level of acculturation was linked to a high level of feeling refreshed when awaken in the morning, which in turn was negatively related to depressive symptoms (D'Anna- Hernandez et al, 2016).…”

Acculturative stress is associated with trajectory of anxiety symptoms during pregnancy in Mexican-American women

“…A final sample of 151 women were included in the analysis. The attrition rate of the current study (14%) is similar that of previous studies that report ∼10–20% attrition in similar pregnant populations (D'Anna-Hernandez, Garcia, Coussons-Read, Laidenslager, & Ross, 2016; Lee et al, 2007). To be eligible to participate in the study, women were at least 18 years old, of Mexican descent, had a singleton pregnancy, were non-smoking and had no current tobacco, illicit, or prescription drug use.…”

The effects of ethnoracial-related stressors during pregnancy on the developing offspring brain

“…Experiences of ethnoracial discrimination are detrimental to the psychological well-being of pregnant women (8) and result in increased infant mortality (9,10) preterm birth (11), and decreased infant birth weight (12). Similar, experiences of acculturation are associated with depression (13)(14)(15)(16)(17), prenatal anxiety (18,19), and stress-particularly, acculturative stress-in pregnant women (20,21). Despite the profound impact these experiences have on a pregnant woman of color and their fetuses, there is little research characterizing the impact of these experiences on brain-based outcomes in offspring.…”