Abstract
OBJECTIVES: To explore the longitudinal associations between maternal sleep, anxiety, depression across pregnancy trimesters and adverse pregnancy outcomes. METHODS: A prospective cohort study was conducted in a maternal and child health hospitals in China from September 2018 to March 2021. Totally of 3147 pregnant women completely participated in this study, who were with complete data available. Measures included Pittsburgh Sleep Quality Index, Self-Rating Anxiety Scale, Self-Rating Depression Scale and pregnancy outcomes to estimate the sleep quality, anxiety, and depression, respectively. RESULTS: Sleep quality of pregnant women in the first trimester pregnancy had not significant association with adverse pregnancy outcomes (p-value > 0.05). However, compared with pregnant women with good sleep quality, women with poor sleep quality in the second trimester pregnancy was associated with 1.421 times risk of adverse pregnancy outcomes (95% CI: 1.037-1.947, p-value < 0.05). In addition, in the second trimester pregnancy, anxiety was associated with a significantly reduced risk of adverse pregnancy outcomes (OR = 0.632, 95% CI: 0.42-0.95, p-value < 0.05), while depression in the second trimester pregnancy was not significantly associated with adverse pregnancy outcomes (p-value > 0.05). Moreover, both anxiety and depression of pregnant women in the third trimester pregnancy were not significantly associated with adverse pregnancy outcomes (p-value > 0.05). CONCLUSION: Longitudinal associations between sleep, anxiety, depression and pregnancy outcomes across pregnancy trimesters indicated that maternal health care workers should focus on changes of the sleep quality, anxiety and depression across pregnancy trimesters, and its effects on pregnancy adverse outcomes.