Investigating the dynamic relations between maternal sleep and depression across pregnancy

Sleep problems and depression symptoms are highly prevalent and dynamic during pregnancy with impacts on both maternal and offspring health. However, few studies have examined their bidirectional relations across pregnancy to determine whether sleep is an independent predictor of later depression symptoms, and vice versa. The purpose of this study is to investigate the dynamic relations between prenatal maternal sleep problems and depression symptoms three times across pregnancy.

Pregnant participants (n = 222) recruited in early pregnancy completed sleep and depression questionnaires at around 17-, 28-, and 35-weeks' gestation. Prenatal maternal sleep quality was assessed using the Pittsburgh Sleep Quality Index, while depression symptoms were assessed using the Edinburgh Postnatal Depression Scale. Cross-lagged panel models were utilized to examine autoregressive and cross-lagged associations between sleep problems and depression symptoms across pregnancy.

Findings reveal that both sleep problems and depression symptoms independently predict one another across pregnancy. All associations covaried for baseline sleep problems and depression symptoms. Specifically, more sleep problems in early pregnancy predicted higher depression symptoms mid-pregnancy (β=.14, p = .011), and elevated depression symptoms in early pregnancy predicted more sleep problems mid-pregnancy (β=.18, p = .002). Similarly, more sleep problems in mid-pregnancy predicted more depression symptoms in late pregnancy (β =.10, p = .029), while depression symptoms in mid-pregnancy predicted more sleep problems during late pregnancy (β=.16, p = .004).

Both prenatal maternal sleep and depression independently predict one another across pregnancy. Assessing sleep in early pregnancy may help with the detection of worsening depression, and vice versa, across the perinatal period.