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Yang C, Fu R, Wang H, Jiang Y, Zhang S, Ji X. Evaluating the global prevalence of insomnia during pregnancy through standardized questionnaires and diagnostic criteria: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1427255. [PMID: 39193579 PMCID: PMC11348333 DOI: 10.3389/fpsyt.2024.1427255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/25/2024] [Indexed: 08/29/2024] Open
Abstract
Introduction Insomnia during pregnancy presents significant medical care challenges and heightens the risk of adverse outcomes for both pregnant women and fetuses. This study undertook a meta-analysis to assess the global prevalence of insomnia during pregnancy, examining both the overall prevalence and regional variations. Method The aim of this study was to perform a meta-analysis of articles indexed in PubMed, Embase, and Web of Science from the inception of these databases up to February 29, 2024. The study systematically reviewed the global prevalence of gestational insomnia and explored potential moderating factors, encompassing research type, publication date, regional influences, maternal age, pregnancy status, depressive symptoms, and anxiety symptoms. Result Forty-four studies, encompassing a total of 47,399,513 participants, were included in the analysis. The overall prevalence of insomnia symptoms during pregnancy was 43.9%. Regional factors and depression emerged as the main factors affecting insomnia, with Europe (53.6%) surpassing North America (41.0%), followed by South America (50.6%) and Asia (40.7%). High depression rates (56.2%) correlated with increased insomnia prevalence compared to low depression rates (39.8%). The type of research and publication date showed no significant impact on the prevalence of insomnia symptoms. Conclusion The meta-analysis results indicated that the prevalence of insomnia symptoms was higher during pregnancy, especially among pregnant women who were in a highly depressed state or located in the European region. Systematic review registration PROSPERO, identifier CRD42018104460.
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Affiliation(s)
- Chengcheng Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rui Fu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huan Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yanjie Jiang
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Shipeng Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoli Ji
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Li Z, Cui S, Wang H, Xiong W, Han Y, Dai W, Xi W, Cui T, Zhang X. Associations of maternal sleep trajectories during pregnancy and adverse perinatal outcomes: a prospective cohort study. Sleep Med 2024; 117:71-78. [PMID: 38513533 DOI: 10.1016/j.sleep.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Sleep problems are common in pregnant women and sleep is altered during pregnancy. However, the associations between sleep trajectory patterns and adverse maternal and neonatal outcomes are unclear. The current study aims to identify sleep trajectory patterns and explore their associations with adverse perinatal outcomes in a prospective cohort study. METHODS Pregnant women (N = 232) completed the Pittsburgh Sleep Quality Index each trimester during pregnancy in Tianjin, China. Perinatal outcomes were extracted from the hospital delivery records. Latent class growth analysis (LCGA) described the trajectories of sleep timing, duration, and efficiency. Multivariable linear regression and multivariable logistic regression were employed to evaluate associations between sleep trajectory patterns and perinatal outcomes. RESULTS Trajectories were identified for bedtime (early, 49.1%; delaying, 50.9%), wake-up time (early, 82.8% of the sample; late, 17.2%), duration (short, 5.2%; adequate 78.0%; excessive, 16.8%), and efficiency (high, 88.4%; decreasing, 11.6%). Compared with women in more optimal sleep groups, those in the late wake-up, excessive duration, and decreasing efficiency groups had babies with shorter birth lengths (β range, -0.50 to -0.28, p < 0.05). Moreover, women in the decreasing efficiency group had babies with lower birth weight (β, -0.44; p < 0.05). Women in the delaying bedtime group had greater odds of preterm delivery (OR, 4.57; p < 0.05), while those in the decreasing efficiency group had greater odds of cesarean section (OR, 3.12; p < 0.05). CONCLUSIONS Less optimal sleep trajectory patterns during pregnancy are associated with perinatal outcomes. Therefore, early assessment of maternal sleep during pregnancy is significant for identifying at-risk women and initiating interventions to reduce perinatal outcomes.
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Affiliation(s)
- Zhi Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Shanshan Cui
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Hui Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Wenjuan Xiong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Yu Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Wei Dai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Wei Xi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Tingkai Cui
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China.
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Kok EY, Kaur S, Mohd Shukri NH, Abdul Razak N, Takahashi M. Development, validation, and reliability of the Chrononutrition Profile Questionnaire-Pregnancy (CPQ-P). BMC Pregnancy Childbirth 2024; 24:217. [PMID: 38521925 PMCID: PMC10960373 DOI: 10.1186/s12884-024-06403-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/11/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND During pregnancy, physiological changes can affect eating and sleeping habits, which may eventually have negative consequences for maternal and foetal health. To better understand these changes, it is essential to develop a reliable questionnaire that addresses lifestyle habits such as snacking and daytime napping. This study aimed to determine the validity and reliability of the Chrononutrition Profile Questionnaire-Pregnancy (CPQ-P). METHODS A total of 399 women in their second and third trimester of pregnancy were recruited from government maternal and child health clinics in Kuala Lumpur and Putrajaya and completed a self-administered online questionnaire. Content validity was conducted with an expert panel consisting of 4 members. Confirmatory factor analysis (CFA) using maximum likelihood was conducted to determine the construct validity. Internal consistency was determined by Cronbach's alpha coefficient (CAC), while the test-retest reliability was conducted using intraclass correlation coefficient (ICC). RESULTS The questionnaire had an appropriate content validity index of 0.91. The CPQ-P consists of 22 items, measuring 5 constructs, including morning chrono-habits, sleeping habits, evening eating, temporal eating, and pregnancy symptoms. The factor model showed good fit with χ2/df = 2.486, GFI = 0.893, CFI = 0.912, and RMSEA = 0.065. The 22 items in CPQ-P showed fair to excellent test-retest reliability (ICC: 0.42 to 0.98). The 5 constructs in CPQ-P were found to have a good to excellent internal consistency (α = 0.612-0.963). CONCLUSIONS The CPQ-P is a valid and reliable tool for assessing lifestyle habits during pregnancy. The questionnaire can be used to identify areas where pregnant women may need additional support or intervention to adopt healthy behaviours and reduce the risk of adverse maternal and foetal outcomes. TRIAL REGISTRATION NCT05700136 (clinicaltrials.gov). Trial registration date: 26/01/2023.
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Affiliation(s)
- Ee Yin Kok
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Cheras, Wilayah Persekutuan Kuala Lumpur, 56000, Malaysia
| | - Satvinder Kaur
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Cheras, Wilayah Persekutuan Kuala Lumpur, 56000, Malaysia.
| | - Nurul Husna Mohd Shukri
- Department of Nutrition, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia
| | - Nurliyana Abdul Razak
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Cheras, Wilayah Persekutuan Kuala Lumpur, 56000, Malaysia
| | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
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Govahi M, Behmanesh F, Gholinia H, Omidvar S, Adib-Rad H. Health-promoting lifestyle in mothers with vaginal childbirth and cesarean section in the postpartum period. BMC Womens Health 2024; 24:146. [PMID: 38409091 PMCID: PMC10898097 DOI: 10.1186/s12905-024-02984-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 02/19/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND In the postpartum period, there are numerous changes in the physical and psychological dimensions of women, which reduce the quality of life of women. The aim of this study was to compare the health-promoting lifestyle of mothers with vaginal delivery and cesarean delivery in the postpartum period. METHODS This cross-sectional study was conducted on 77 pregnant women who had delivered vaginal or by cesarean section at Shohadaye Behshahr Hospital and were selected based on inclusion criteria. If the women were willing to participate in the study, a demographic questionnaire was completed, and the telephone numbers of the subjects were recorded so that the Porsline health-promoting lifestyle questionnaire could be sent to them. Data were analyzed with SPSS 22 using the T test, chi-square test and Repeated Measure ANOVA. RESULTS There was no difference in the average score of health-promoting lifestyle and its dimensions between the two groups of vaginal delivery and cesarean section at two and six weeks after delivery. However, in both groups, the total score of health-promoting lifestyle decreased significantly over time (P < 0.001). CONCLUSIONS There was no difference in health-promoting lifestyle between mothers with vaginal and mothers with cesarean delivery at two weeks and six weeks after delivery. This requires more attention from policy makers to make vaginal childbirth more convenient, and by reducing complications after vaginal childbirth, they can improve women's healthy lifestyles and, in turn, families. Also, it seems that the other variables apart from the method of delivery should be considered, and it is necessary to distinguish these variables such as routine episiotomy in order to prevent the decrease in the level of health-promoting behaviors among women during puerperium period.
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Affiliation(s)
- Motahareh Govahi
- Student Research Committee, Babol University of Medical Sciences, Babol, I.R. of Iran
| | - Fereshteh Behmanesh
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran.
| | - Hemmat Gholinia
- Health research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran
| | - Hajar Adib-Rad
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. of Iran
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M’Koma AE, Ware JN, Nabaweesi RK, Chirwa SS. Managing Pregnancy and Nursing Affecting African American Women with Inflammatory Bowel Disease: Clinical Outcomes and Parenthood. MEDICAL RESEARCH ARCHIVES 2023; 11:3784. [PMID: 37492395 PMCID: PMC10367541 DOI: 10.18103/mra.v11i6.3784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Inflammatory bowel disease (IBD) is a term for two autoimmune diseases encompassing Crohn's disease (CD) and ulcerative colitis (UC) which are lifelong diseases affecting more than 3 million adults (1.3%) in the United States. IBD is characterized by chronic inflammation of the whole digestive system which results in damage to the gastrointestinal (GI) tract. IBD often emerges during adolescence and young adulthood. Maternal morbidity includes physical and psychological conditions that result from or are aggravated by pregnancy and have an adverse effect on a woman's health, the baby's health or both. Some women have health challenges that arise before or during pregnancy that could lead to complications. It is recommended for women to receive health care counseling before and during pregnancy. Compared to other developed countries, the United States has the highest rate of women dying of pregnancy related complications. During the past 25 years maternal mortality has been getting worse. African American women (AAW) with and/or without IBD are dying at significantly higher rates than other groups. This is linked to several factors, i.e., systemic, institutionalized, and structural racism in health-care delivery and subsequent toxic stress from people's lived experiences of racism, limited knowledge about healthcare system function, lack of access to healthcare, (inclusiveness and insurance policies) all of which negatively impact these patients. African Americans (AAs) are also up to three times as likely to experience severe maternal morbidity: unexpected outcomes of labor and delivery, deficient or lacking prenatal care and social determinants of health like lack of transportation, adequate employment, limited literacy, and limited healthcare access contribute to poor health outcomes. Studies on IBD patients indicate Medicaid expansion is associated with reduced rates of maternal morbidity, particularly for African American Women (AAW) and increased access to preconception and prenatal services that make pregnancy and childbirth safer for parent and baby. Herein we examine the physiological changes of pregnancy in patients diagnosed with inflammatory bowel disease and their relationship perinatal outcomes and parenthood.
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Affiliation(s)
- Amosy E. M’Koma
- Departments of Biochemistry, Cancer Biology, Neuroscience and Pharmacology
| | | | | | - Sanika S. Chirwa
- Departments of Biochemistry, Cancer Biology, Neuroscience and Pharmacology
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Felix NAR, Ceolim MF. O sono nos trimestres gestacionais: um estudo longitudinal. Rev Gaucha Enferm 2023. [DOI: 10.1590/1983-1447.2023.20210278.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivo: Identificar as características do sono e os fatores associados ao sono de má qualidade ao longo dos trimestres gestacionais. Método: Estudo longitudinal, quantitativo, com três períodos de acompanhamento, nos trimestres gestacionais (denominados T1, T2 e T3). Estudo longitudinal com 50 gestantes sem comorbidades. Utilizou-se os instrumentos: caracterização sociodemográfica e clínica, Índice de Qualidade do Sono de Pittsburgh e Diário de Sono. Os dados foram analisados por testes estatísticos (Qui-quadrado, testes não paramétricos e modelos de regressão). Resultados: Identificou-se que 55,3% das gestantes relataram sono de má qualidade em T1, 39,5% em T2 e 65,8% em T3 e que, em T3, houve 67% a mais de risco de relatos de sono de má qualidade do que em T2. Conclusão: Considerando-se a elevada prevalência de má qualidade do sono, principalmente no terceiro trimestre, compreende-se o pré-natal como um momento de aprendizado e oportunidade para os enfermeiros desenvolverem ações de educação, orientação e higiene do sono.
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Felix NAR, Ceolim MF. Sleep in pregnancy quarters: a longitudinal study. Rev Gaucha Enferm 2022; 44:e20210278. [PMID: 36541948 DOI: 10.1590/1983-1447.2023.20210278.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/09/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To identify sleep characteristics and factors associated with sleep issues during pregnancy. METHOD This is a longitudinal, with three follow-up periods at each gestational trimester (called T1, T2 and T3). Fifty (50) pregnant women without comorbidities started the study. The following instruments were used: sociodemographic and clinical characterization, Pittsburgh Sleep Quality Index and Sleep Diary. Data were analyzed using statistical tests (Chi-square, non-parametric tests and regression models). RESULTS We identified that 55.3% of the pregnant women reported sleep disorders in T1, 39.5% in T2, and 65.8% in T3; in T3, the risk of reporting sleep problems increased by 67% in comparison with T2. CONCLUSION Considering the high prevalence of poor-quality sleep, especially in the third trimester, prenatal care is understood as a moment of intense learning and an opportunity for nurses to develop actions concerning education, guidance and sleep hygiene.
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Affiliation(s)
| | - Maria Filomena Ceolim
- Universidade Estadual de Campinas (Unicamp), Faculdade de Enfermagem. Campinas, São Paulo, Brasil
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Davidsen AS, Birkmose AR, Kragstrup J, Siersma V, Ertmann RK. The association of a past childbirth experience with a variety of early physical and mental symptoms in subsequent pregnancies. Midwifery 2022; 112:103406. [PMID: 35772244 DOI: 10.1016/j.midw.2022.103406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Some women have a perceived negative experience of childbirth due to various reasons- e.g., obstetric complications or the feeling of loss of control. We do not know enough about the effects of a perceived negative experience of a childbirth on a woman's subsequent pregnancies. The aim of this study was to investigate whether a previously perceived negative childbirth experience affects a woman's physical and mental well-being in a later pregnancy. METHODS A prospective cohort study in Danish general practice, based on information about women's childbirth experiences from the Pregnancy Health Record filled in by the general practitioner (GP) and data from an electronic questionnaire completed by the women. RESULTS A total of 1288 women were included in the analysis. Women who had given birth before were found to have a significantly higher risk of experiencing nausea, varicose veins and uterine contractions, and a lower risk of pelvic cavity pain in the current pregnancy. Women having given birth before were significantly more likely to assess their physical fitness as poor and to experience poor well-being. Women with a perceived negative experience of childbirth had more sleep problems and a higher prevalence of poor self-rated health than women with unproblematic childbirth experience. CONCLUSION This study showed that women with a previously perceived negative experience of childbirth are affected according to their mental health in their subsequent pregnancy.
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Affiliation(s)
- Agnes S Davidsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Anna R Birkmose
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Kragstrup
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ruth K Ertmann
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Palagini L, Bramante A, Baglioni C, Tang N, Grassi L, Altena E, Johann AF, Geoffroy PA, Biggio G, Mencacci C, Sharma V, Riemann D. Insomnia evaluation and treatment during peripartum: a joint position paper from the European Insomnia Network task force "Sleep and Women," the Italian Marcè Society and international experts task force for perinatal mental health. Arch Womens Ment Health 2022; 25:561-575. [PMID: 35419652 PMCID: PMC9072480 DOI: 10.1007/s00737-022-01226-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 03/27/2022] [Indexed: 12/22/2022]
Abstract
Insomnia symptoms are frequent during peripartum and are considered risk factors for peripartum psychopathology. Assessing and treating insomnia and related conditions of sleep loss during peripartum should be a priority in the clinical practice. The aim of this paper was to conduct a systematic review on insomnia evaluation and treatment during peripartum which may be useful for clinicians. The literature review was carried out between January 2000 and May 2021 on the evaluation and treatment of insomnia during the peripartum period. The PubMed, PsycINFO, and Embase electronic databases were searched for literature published according to the PRISMA guidance with several combinations of search terms "insomnia" and "perinatal period" or "pregnancy" or "post partum" or "lactation" or "breastfeeding" and "evaluation" and "treatment." Based on this search, 136 articles about insomnia evaluation and 335 articles on insomnia treatment were found and we conducted at the end a narrative review. According to the inclusion/exclusion criteria, 41 articles were selected for the evaluation part and 22 on the treatment part, including the most recent meta-analyses and systematic reviews. Evaluation of insomnia during peripartum, as for insomnia patients, may be conducted at least throughout a clinical interview, but specific rating scales are available and may be useful for assessment. Cognitive behavioral therapy for insomnia (CBT-I), as for insomnia patients, should be the preferred treatment choice during peripartum, and it may be useful to also improve mood, anxiety symptoms, and fatigue. Pharmacological treatment may be considered when women who present with severe forms of insomnia symptoms do not respond to nonpharmacologic therapy.
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Affiliation(s)
- Laura Palagini
- Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
- Department of Neuroscience and Rehabilitation, Section of Psychiatry, University of Ferrara, Via Fossato Mortara 64, 44121, Ferrara, Italy.
| | | | - Chiara Baglioni
- Department of Psychiatry and Psychotherapy, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Human Sciences, University of Rome 'G. Marconi' - Telematic, Rome, Italy
| | - Nicole Tang
- Department of Psychology, Warwick Sleep and Pain Lab, University of Warwick, Coventry, UK
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, Section of Psychiatry, University of Ferrara, Via Fossato Mortara 64, 44121, Ferrara, Italy
| | - Ellemarije Altena
- SANPSY-USR CNRS, 3413-Sommeil, Addiction et Neuropsychiatrie, Université de Bordeaux, Bordeaux, France
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Pierre Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, Hopital Bichat - Claude Bernard, Paris, France
| | - Giovanni Biggio
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Claudio Mencacci
- President, Italian Society of Neuropsychopharmacology, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Verinder Sharma
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center- University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Alimoradi Z, Abdi F, Gozal D, Pakpour AH. Estimation of sleep problems among pregnant women during COVID-19 pandemic: a systematic review and meta-analysis. BMJ Open 2022; 12:e056044. [PMID: 35379627 PMCID: PMC8980733 DOI: 10.1136/bmjopen-2021-056044] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To estimate the sleep problems among pregnant women during the COVID-19 pandemic. ELIGIBILITY CRITERIA English, peer-reviewed, observational studies published between December 2019 and July 2021 which assessed and reported sleep problem prevalence using a valid and reliable measure were included. INFORMATION SOURCES Scopus, Medline/PubMed Central, ProQuest, ISI Web of Knowledge and Embase. RISK OF BIAS ASSESSMENT TOOL The Newcastle-Ottawa Scale checklist. SYNTHESIS OF RESULTS Prevalence of sleep problems was synthesised using STATA software V.14 using a random effects model. To assess moderator analysis, meta-regression was carried out. Funnel plot and Egger's test were used to assess publication bias. Meta-trim was used to correct probable publication bias. The jackknife method was used for sensitivity analysis. INCLUDED STUDIES A total of seven cross-sectional studies with 2808 participants from four countries were included. SYNTHESIS OF RESULTS The pooled estimated prevalence of sleep problems was 56% (95% CI 23% to 88%, I2=99.81%, Tau2=0.19). Due to the probability of publication bias, the fill-and-trim method was used to correct the estimated pooled measure, which imputed four studies. The corrected results based on this method showed that pooled prevalence of sleep problems was 13% (95% CI 0% to 45%; p<0.001). Based on meta-regression, age was the only significant predictor of prevalence of sleep problems among pregnant women. LIMITATIONS OF EVIDENCE All studies were cross-sectional absence of assessment of sleep problems prior to COVID-19, and the outcomes of the pregnancies among those with and without sleep problems in a consistent manner are among the limitation of the current review. INTERPRETATION Pregnant women have experienced significant declines in sleep quality when faced with the COVID-19 pandemic. The short-term and long-term implications of such alterations in sleep on gestational and offspring outcomes are unclear and warrant further studies. PROSPERO REGISTRATION NUMBER CRD42020181644.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Abdi
- School of Nursing and Midwifery, Alborz University of Medical Sciences, Karaj, Iran
| | - David Gozal
- Department of Child Health and Child Health Research Institute, University of Missouri, Columbia, Missouri, USA
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Wang R, Xu M, Yang W, Xie G, Yang L, Shang L, Zhang B, Guo L, Yue J, Zeng L, Chung MC. Maternal sleep during pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis. J Diabetes Investig 2022; 13:1262-1276. [PMID: 35171528 PMCID: PMC9248434 DOI: 10.1111/jdi.13770] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/26/2022] [Accepted: 02/11/2022] [Indexed: 11/28/2022] Open
Abstract
AIM/INTRODUCTION Sleep problem is an important public health concern worldwide. We conducted a meta-analysis to quantitatively evaluate whether sleep duration associated with pregnancy outcomes, and the associations were modified by important characteristics of studies. MATERIALS AND METHODS Basing on PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) databases, we searched for the published literature related to maternal sleep duration and adverse pregnancy outcomes before 30 June, 2021. We conducted risk of bias assessment, subgroup analyses and sensitivity analysis. The relative risks (RR) or odds ratios (OR) with 95% confidence intervals (CI) were used to estimate the pooled effects. RESULTS 5246 references were identified through databases searching, 41 studies were included in the study. Pregnant with short sleep duration had 1.81 times (95% CI 1.35-2.44, P < 0.001) risk of gestational diabetes mellitus (GDM). The association between short sleep duration and the risk of gestational hypertension (GH), cesarean section (CS), low birthweight (LBW), preterm birth (PTB) and small for gestational age (SGA) were not significant (P > 0.05). Furthermore, long sleep duration was significantly correlated with GDM (OR 1.24. 95% CI 1.12-1.36, P < 0.001) and CS (OR 1.13. 95% CI 1.04-1.22, P = 0.004), while long sleep duration was not linked with GH, LBW, PTB and SGA (P > 0.05). CONCLUSIONS Short / long sleep duration appeared to be associated with adverse pregnancy outcome, specifically with an increased risk of GDM. Sleep should be systematically screened in the obstetric population.
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Affiliation(s)
- Ruiqi Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Mengmeng Xu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Guilan Xie
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Liren Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Li Shang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China.,Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, P.R. China
| | - Boxing Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Leqian Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Jie Yue
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Mei Chun Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Massachusetts Boston, United States of America
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12
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Sedov ID, Anderson NJ, Dhillon AK, Tomfohr-Madsen LM. Insomnia symptoms during pregnancy: A meta-analysis. J Sleep Res 2020; 30:e13207. [PMID: 33140514 DOI: 10.1111/jsr.13207] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 11/28/2022]
Abstract
Reports of sleep disturbances are common during pregnancy, yet estimates of prevalence of insomnia symptoms during pregnancy vary widely. The goals of the current review were to summarize the existing data on prevalence of insomnia symptoms during pregnancy and to explore potential moderators, including trimester, gestational age, maternal age, symptoms of anxiety and symptoms of depression. A systematic search of PubMed, PsycInfo and Web of Science was conducted for articles published from inception up to June 2020. In total, 24 studies with a total of 15,564 participants were included in the analysis. The overall prevalence of insomnia symptoms during pregnancy was 38.2%. Trimester was a significant moderator, such that prevalence of insomnia symptoms was higher in the third trimester (39.7%) compared to first (25.3%) and second (27.2%) trimesters. No other variables significantly moderated the prevalence of insomnia symptoms. The results of the current meta-analysis suggest that the prevalence of insomnia symptoms is higher during pregnancy, particularly in the third trimester. Future research should examine the efficacy and safety of insomnia treatments with this population.
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Affiliation(s)
- Ivan D Sedov
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - Ashley K Dhillon
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Lianne M Tomfohr-Madsen
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute for Child and Maternal Health (ACHRI), Calgary, AB, Canada.,Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada
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13
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Lucena L, Frange C, Pinto ACA, Andersen ML, Tufik S, Hachul H. Mindfulness interventions during pregnancy: A narrative review. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2020; 18:470-477. [PMID: 32798196 DOI: 10.1016/j.joim.2020.07.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/10/2020] [Indexed: 12/14/2022]
Abstract
Pregnancy is a period of major transformations in a woman's life; increased stress, and mood and sleep disorders are frequent. This review evaluates mindfulness interventions during pregnancy and their ability to help manage stress, anxiety, depression, emotional regulation, level of mindfulness and sleep quality. A search of English language scientific literature relevant to mindfulness interventions for pregnant women was conducted using PubMed, Scopus and Web of Science, without restriction on publication date. Inclusion criteria were randomized clinical trials with pregnant women, using mindfulness as an intervention for at least three weeks, in one of our main areas of interest, and using only validated scales to measure outcomes. Two hundred and thirty studies were identified in our searches of research databases, and thirteen were included in our analysis. We found a large diversity of mindfulness programs, heterogeneity among the instruments used to evaluate outcomes, and inconsistency in the gestational periods used in the studies. Mindfulness interventions were beneficial for stress, anxiety and depression. Mindfulness was also effective when applied in pregnant women with a history of depression or experiencing depression. Considering emotional regulation and the level of mindfulness, there were signs of improvement, but more studies are needed. None of the studies evaluated sleep quality. Our review provides information about current mindfulness programs, an overview of the effects of mindfulness interventions, a description of the measurements used so far, and recommendations for developing high-quality mindfulness protocols for pregnant women.
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Affiliation(s)
- Leandro Lucena
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Cristina Frange
- Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), São Paulo 04039002, Brazil
| | - Ana Claudia Amorim Pinto
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Monica Levy Andersen
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil
| | - Helena Hachul
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023062, Brazil; Department of Gynecology, Universidade Federal de São Paulo (UNIFESP), São Paulo 04024002, Brazil.
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