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Postpartum depressive symptoms and its association to daytime sleepiness and restless legs during pregnancy
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
2016 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, 137Article in journal (Refereed) Published
Abstract [en]

Purpose: To investigate the possible association between depressive symptoms in the postpartum period and sleep related problems during pregnancy, using screening instruments.

Methods: In a prospective study 293 women in the last trimester of pregnancy answered a questionnaire about sleep related problems in terms of symptoms of restless legs, snoring and daytime sleepiness. They also completed the Epworth Sleepiness Scale (ESS). The same women were screened for depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) four to ten weeks after giving birth. Additional information about social data, pregnancy and delivery was received from the medical charts.

Results: Women with postpartum depressive symptoms had higher prevalence of sleep related problems including excessive daytime sleepiness defined as ESS score ≥10 (OR 3.84, CI 1.57-9.39), and restless legs syndrome (OR 2.837 CI 1.18-6.84) in last trimester of pregnancy, when adjusted for sociodemographic factors and obstetric risk factors.

Conclusions: Depressive symptoms after childbirth are preceded by disturbed sleep already during pregnancy. The results from Epworth Sleepiness Scale completed during pregnancy might be used for detecting women at risk, enabling preventive interventions.

Place, publisher, year, edition, pages
BioMed Central, 2016. 137
Keyword [en]
Postnatal depression, sleep, restless legs syndrome, pregnancy, Epworth Sleepiness Scale
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-117867DOI: 10.1186/s12884-016-0917-9ISI: 000377160400001OAI: oai:DiVA.org:liu-117867DiVA: diva2:811469
Note

Funding agencies: This investigation was supported by grants from The Regional Council of Ostergotland, Sweden.

Vid tiden för disputationen förelåg publikationen endast som manuskript

Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2016-06-23Bibliographically approved
In thesis
1. Sleep disorders during pregnancy
Open this publication in new window or tab >>Sleep disorders during pregnancy
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Sleep disorders are known to increase in prevalence during pregnancy, and associations between disturbed sleep during pregnancy and adverse outcomes for mother and child have been reported in a number of studies. However, most of these studies were retrospective and too small to satisfactorily demonstrate the association.

Aims

  • To prospectively investigate the development of snoring during pregnancy and assess if there is an association between snoring and sleepiness or adverse pregnancy outcomes.
  • To study the development of restless legs syndrome during and after pregnancy, and whether it is associated with snoring or other pregnancy-related symptoms.
  • To investigate the possible association between depressive symptoms in the postpartum period and sleep related problems during pregnancy, using screening instruments.
  • To objectively evaluate sleep disordered breathing in pregnant women compared to non-pregnant controls and to evaluate differences in Epworth Sleepiness Scale scores between the two groups.

Methods

Questionnaires containing subjective rating of snoring, Epworth Sleepiness Scale and symptoms of restless legs were used in all studies. Information from the medical records of the pregnant women was also utilized. For objective evaluation of sleep disordered breathing, nocturnal respiratory recordings were used. In the research for the first three papers the same cohort of 500 pregnant women was followed on three occasions during pregnancy and also after delivery, and for the last paper, 100 other pregnant women were compared to 80 nonpregnant controls.

Results and conclusions

Both snoring and restless legs syndrome increase during pregnancy, but this had no convincing impact on obstetric outcome. Sleep recordings could not verify an increased prevalence of obstructive sleep apnea among pregnant women. Restless legs syndrome was associated with snoring and could persist after delivery. Women who had high scores on the Epworth Sleepiness Scale in the last trimester of pregnancy showed more depressive symptoms in the postpartum period. No difference in item scoring of the Epworth Sleepiness Scale was found between pregnant women and controls.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 80 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1446
National Category
Public Health, Global Health, Social Medicine and Epidemiology Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-117869 (URN)10.3384/diss.diva-117869 (DOI)978-91-7519-121-8 (print) (ISBN)
Public defence
2015-05-29, Berzeliussalen, Ingång 65, Campus US, Linköpiong, 09:00 (English)
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Available from: 2015-05-12 Created: 2015-05-12 Last updated: 2016-04-24Bibliographically approved

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Sarberg, MariaBladh, MarieSvanborg, EvaJosefsson, Ann
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Division of Clinical SciencesFaculty of Health SciencesDepartment of Gynaecology and Obstetrics in LinköpingDivision of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDepartment of Clinical Neurophysiology
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BMC Pregnancy and Childbirth
Public Health, Global Health, Social Medicine and Epidemiology

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