The predictive effect of mid-pregnancy sleep disorders on perinatal depression within women with or without depression in early pregnancy: A prospective cohort study

Background: To investigate the relationship between depression in early pregnancy and sleep quality in midpregnancy, and explore whether sleep disorders independently predicts depression across the perinatal period within women with or without depression in early pregnancy.Methods: Data were collected at 7 time points from 12 weeks of pregnancy to 6 weeks postpartum. Multiple logistic regression and survival analysis were used to explore the relationship between sleep quality in midpregnancy and perinatal depression within women with or without depression in early pregnancy.Results: 390 women were included. Women with depression in early pregnancy were more likely to have sleep disorders and perinatal depression. Women with sleep disorders had a higher risk of perinatal depression compared to women without sleep disorders in mid-pregnancy. Stratified analysis based on whether depressed at 12 weeks of pregnancy found that among women without depression, those with sleep disorders in midpregnancy were more likely to have subsequent perinatal depression and appeared earlier; whereas, among women with depression, mid-pregnancy sleep disorders was not a predictor of subsequent perinatal depression.Limitation: High rates of missed visits may lead to sample bias, with depression and sleep quality being assessed by self-report. Conclusions: Women with depression in early pregnancy are more likely to have sleep disorders in midpregnancy. There is a strong correlation between sleep quality in mid-pregnancy and perinatal depression among women without depression in early pregnancy. Routine screening and intervention for sleep disorders should be a priority in perinatal care to reduce the incidence of perinatal depression.