Relations between pregnancy insomnia, relationship conflict, and stress during the COVID-19 pandemic: From pregnancy through early parenthood

Poor sleep quality and relationship conflict are associated with higher perinatal stress. However, there is limited longitudinal research examining the combined and interactive impact of sleep quality and relationship conflict on stress across pregnancy and postpartum. Participants (n = 297) were recruited during the COVID-19 pandemic and completed measures of insomnia and relationship conflict in pregnancy and perceived stress from pregnancy to 35-months postpartum. Structural equation regression and moderated mediation analyses were conducted in R to investigate longitudinal associations. Results indicate that both greater insomnia symptoms and higher relationship conflict in pregnancy predict higher perceived stress in pregnancy (β = 0.349-0.418, p < .001) and the postpartum (β = 0.148-0.239, p = .011). Relationship conflict significantly moderated the effect of insomnia symptoms on perceived stress in pregnancy (β = -0.114, p = .024) and the postpartum (β = -0.129, p = .013), such that at lower levels of relationship conflict, individuals with lower insomnia symptoms report the lowest levels of perceived stress. Perceived stress during pregnancy significantly mediated the relationship between insomnia and postpartum stress, however, this indirect path was not significantly moderated by relationship conflict. Relationship conflict moderated the direct association between insomnia symptoms and postpartum perceived stress, which was significant at lower (β = 0.095, p = .001), but not higher (β = 0.047, p = .106) levels of relationship conflict. Findings highlight the interactive and mechanistic associations between sleep problems, relationship hardship and stress during pregnancy and the first 3 years postpartum. Targeting sleep problems and supporting healthy relationship dynamics may help mitigate sustained stress for parents.