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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


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1619-3997
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Volume 47, Issue 7

Issues

Poor sleep quality is associated with perinatal depression. A systematic review of last decade scientific literature and meta-analysis

Ernesto González-MesaORCID iD: https://orcid.org/0000-0002-7106-092X
  • Corresponding author
  • Surgical Specialties, Biochemistry and Immunology Department, Malaga University School of Medicine, 32, Boulevard Louis Pasteur, 29071 Málaga, Spain
  • Obstetrics and Gynecology at Malaga University Hospital, Málaga, Spain
  • orcid.org/0000-0002-7106-092X
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Celia Cuenca-Marín / María Suarez-Arana / Beatriz Tripiana-Serrano / Nadia Ibrahim-Díez / Ana Gonzalez-Cazorla
  • Surgical Specialties, Biochemistry and Immunology Department, Malaga University School of Medicine, 32, Boulevard Louis Pasteur, 29071 Málaga, Spain
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Marta Blasco-Alonso
Published Online: 2019-08-06 | DOI: https://doi.org/10.1515/jpm-2019-0214

Abstract

Background

Although pregnancy is frequently associated with mental states of happiness, hope and well-being, some physical and psychological changes can contribute to increased sleep disturbances and worsened sleep quality. Sleep quality has been linked to negative emotions, anxiety and depression. The main objective of this paper was to systematically review the impact of sleep during pregnancy on maternal mood, studying the association between objective and subjective measures of sleep quality and perinatal depression.

Methods

We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, which included studies published between January 2008 and April 2019, and met the following criteria: (i) studies on pregnant women assessing the effects of sleep quality variables on perinatal mood disorders, (ii) studies published in English and (iii) full paper published in a peer-reviewed scientific journal with full-text format available.

Results

A total of 36 studies published in the last decade met the inclusion criteria for qualitative review and eight of them were suitable for meta-analysis. Both confirmed the negative effects of poor sleep on perinatal mood. However, qualitative analysis showed that unrepresentative samples and low participation rates falling below 80% biased some of the studies. The standard random-effects meta-analysis showed a pooled size effect [ln odds ratio (OR) 1.49 (95% confidence interval [CI] 1.19, 1.79)] for perinatal depression in cases of poor prenatal sleep quality, although heterogeneity was moderate to high [Q 16.05, P ≤ 0.025, H2 2.45 (95% CI 1.01, 13.70)].

Conclusion

Poor sleep quality was associated with perinatal mood disturbances. The assessment of sleep quality along the pregnancy could be advisable with a view to offering preventative or therapeutic interventions when necessary.

Keywords: mood disorder; perinatal depression; sleep disturbance; sleep quality

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About the article

Corresponding author: Prof. Ernesto González-Mesa, MD, PHD, Surgical Specialties, Biochemistry and Immunology Department, Malaga University School of Medicine, 32, Boulevard Louis Pasteur, 29071 Málaga, Spain; and Obstetrics and Gynecology at Malaga University Hospital, Málaga, Spain


Received: 2019-06-12

Accepted: 2019-07-17

Published Online: 2019-08-06

Published in Print: 2019-09-25


Author contributions: All authors participated in the design of search strategy and in the review of the included articles. EGM wrote the Methods and Discussion and submitted the article. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Journal of Perinatal Medicine, Volume 47, Issue 7, Pages 689–703, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2019-0214.

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