Sleep disturbances and depressive and anxiety symptoms during pregnancy: associations with delivery and new-born health

Abstract

Abstract Background: Sleep disturbances and mood symptoms are common in late pregnancy and they contribute to the decline in daytime quality of health and life in expecting mothers. This study evaluated the effect of these disturbances on delivery and new-born health as these associations have been insufficiently covered in the previous literature.Methods: A cohort of 1414 mothers was enrolled in the third trimester to this prospective cross-sectional questionnaire study. Basic Nordic Sleep Questionnaire was assessed for measurement of sleep quality and sleep length, Epworth sleepiness scale for sleepiness, the Center for Epidemiologic Studies Depression Scale for depression and State-Trait Anxiety Inventory for anxiety. The data on delivery and new-born 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. 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, these findings regarding birth weight lost their significance when the birth weight was standardized with gestational weeks. 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 who suffered from high 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 very depressive and anxious mothers 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 new-born health. However, in this normative sample nearly all the outcomes fell within a normal range, implying that the actual risks are low.