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. 2025 Feb;51(2):e16219.
doi: 10.1111/jog.16219.

Association between sleep problems during pregnancy and postpartum depressive symptoms as well as condition of newborn at delivery

Yoko Komada  1 , Sho-Ichi Kawakami  2 , Satoko Furuie  3 , Rena Mori  1 , Azusa Ikegami  3
Affiliations

Association between sleep problems during pregnancy and postpartum depressive symptoms as well as condition of newborn at delivery

Yoko Komada et al. J Obstet Gynaecol Res. 2025 Feb.

Abstract

Background: Pregnancy-related anatomic, physiologic, and hormonal factors can occur at different stages of pregnancy and affect sleep disturbances. The relationship between sleep problems during pregnancy and postpartum depressive symptoms as well as neonatal condition at delivery have not been well described. This study hypothesized that sleep problems are associated with postpartum depressive symptoms and adverse neonatal outcomes at delivery.

Methods: This study conducted a prospective study for perinatal women (n = 683, 30.54 ± 5.11 years old) to evaluate sleep problems during pregnancy using the Pittsburgh sleep quality index (PSQI) and Berlin questionnaire, postpartum depressive symptoms using Edinburgh postnatal depression scale (EPDS), and clinical signs of neonatal condition at delivery using the Apgar score.

Results: PSQI total score during pregnancy were significantly higher in those with postpartum depressive symptoms than those without 1 month after delivery. PSQI score in the third trimester was significantly associated with postpartum depressive symptoms even after adjustment for relevant confounding factors and self-reported lifetime depression (odds ratio = 1.19, 95% confidence interval = 1.03-1.36, p = 0.015). The Apgar score at 5 min after birth was significantly lower in those with obstructive sleep apnea (OSA) than those without OSA in the second and third trimesters, although mean scores were within the normal range.

Conclusion: This study revealed that sleep problems during pregnancy influence postpartum depression 1 month after delivery. OSA during pregnancy may lead to risks of delivery. Attention should be paid to sleep health during pregnancy to ensure the mental health of mothers and a safe delivery.

Keywords: Apgar score; postpartum depression; pregnancy; sleep apnea; sleep problem.

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Conflict of interest statement

Yoko Komada received honorarium from Eisai co. Sho‐Ichi Kawakami received grants or lecture fees from Tsumura & Co., Kracie Holdings, Ltd., Bayer Yakuhin, Ltd., and Pfizer Japan Inc. outside the submitted work. Azusa Ikegami received grants or lecture fee from Esai Corp., MSD Corp., Takeda Pharmaceutical, Astrazeneca Corp., Teijin Healthcare Ltd., Novartis Pharma Corp., Towa Pharmaceutica, ResMed, Taisyo Pharma. Co., Idorsia Pharmaceuticals Japan Ltd., outside the submitted work. Satoko Furuie and Rena Mori declare no competing interests.

Figures

FIGURE 1
FIGURE 1
Study protocol.
FIGURE 2
FIGURE 2
Comparison of Apgar score between the groups with/without obstructive sleep apnea during pregnancy in the second trimester (a), in the third trimester (b).
See this image and copyright information in PMC

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