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      Poor Sleep Quality, Antepartum Depression and Suicidal Ideation among Pregnant Women

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          Abstract

          Objective

          To evaluate the independent and combined associations of maternal self-reported poor sleep quality and antepartum depression with suicidal ideation during the third trimester

          Methods

          A cross-sectional study was conducted among 1,298 pregnant women (between 24 and 28 gestational weeks) attending prenatal clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9). The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to assess sleep quality. Multivariate logistical regression procedures were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) after adjusting for putative confounders.

          Results

          Approximately, 17% of women were classified as having poor sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5). Further, the prevalence of antepartum depression and suicidal ideation were 10.3% and 8.5%, respectively in this cohort. After adjusting for confounders including depression, poor sleep quality was associated with a 2.81-fold increased odds of suicidal ideation (OR=2.81; 95% CI 1.78–4.45). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in a 28% increase in odds for suicidal ideation, even after adjusting for depression (OR=1.28; 95% CI 1.15–1.41). The odds of suicidal ideation was particularly high among depressed women with poor sleep quality (OR=13.56 95% CI 7.53–24.41) as compared with women without either risk factor.

          Limitations

          This cross-sectional study utilized self-reported data. Causality cannot be inferred, and results may not be fully generalizable.

          Conclusion

          Poor sleep quality, even after adjusting for depression, is associated with antepartum suicidal ideation. Our findings support the need to explore sleep-focused interventions for pregnant women.

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          Author and article information

          Journal
          7906073
          4424
          J Affect Disord
          J Affect Disord
          Journal of affective disorders
          0165-0327
          1573-2517
          9 December 2016
          18 November 2016
          February 2017
          01 February 2018
          : 209
          : 195-200
          Affiliations
          [a ]Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
          [c ]Instituto Nacional Materno Perinatal de Lima, Lima, Perú
          [d ]Departamentos de Medicina y Ginecología y Obstetricia Universidad Nacional Mayor de San Marcos, Lima, Perú
          [e ]Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA
          [f ]School of Sport and Exercise, Massey University, Wellington, New Zealand
          [g ]Department of Epidemiology and Population Health. London School of Hygiene and Tropical Medicine, London, UK
          [h ]Asociación Civil PROESA, Lima, Peru
          [i ]Universidad Peruana de Ciencias Aplicados, Lima, Peru
          Author notes
          Corresponding author: Bizu Gelaye, PhD, MPH, Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA., Tel: 617-432-1071, Fax: 617-566-7805, bgelaye@ 123456hsph.harvard.edu
          [b]

          These authors contributed equally to this work

          Article
          PMC5360461 PMC5360461 5360461 nihpa835052
          10.1016/j.jad.2016.11.020
          5360461
          27930912
          095372ce-ae28-4e92-9034-529547ae5db7
          History
          Categories
          Article

          depression,suicide,sleep,pregnancy,Peru
          depression, suicide, sleep, pregnancy, Peru

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