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Sleep problems and depressed mood negatively impact health-related quality of life during pregnancy

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Abstract

The objectives of this study were to evaluate and identify determinants of health related quality of life (HRQoL) during pregnancy. Pregnant women (n = 245) completed questionnaires measuring: HRQoL (Short Form Health Survey SF-36), life stress, social support, sleep, and depressed mood in the third trimester. Demographics and medical variables were also collected. Compared to Canadian normative data, our sample scored significantly poorer on the following HRQoL domains: physical functioning, role limitations due to physical health problems, bodily pain, vitality, and social functioning. Multivariate linear regressions were used to model each of the SF-36 subscales. Experiencing sleep problems emerged as a significant determinant of poorer HRQoL in all domains, with the exception of emotional role. Higher depressed mood scores was independently associated with lower HRQoL in six of the eight domains, including bodily pain, general health, vitality, social functioning, emotional role, and mental health. Greater pregnancy-related anxiety was independently associated with lower scores on physical functioning and role limitations due to physical health problems. Women experience lower HRQoL during pregnancy, particularly in the physical domains. The importance of identifying and managing modifiable determinants early in pregnancy to enhance maternal health status is discussed.

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References

  • Beebe KR, Lee KA (2007) Sleep disturbance in late pregnancy and early labor. J Perinat Neonatal Nurs 21:103–108

    PubMed  Google Scholar 

  • Bennett HA, Einarson A, Taddio A et al (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103:698–709

    PubMed  Google Scholar 

  • Brink E, Grankvist G, Karlson BW et al (2005) Health-related quality of life in women and men one year after acute myocardial infarction. Qual Life Res 14:749–757

    Article  PubMed  Google Scholar 

  • Buysse DJ, Ancoli-Israel S, Edinger JD et al (2006) Recommendations for a standard research assessment of insomnia. Sleep 29:1155–1173

    PubMed  Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786

    Article  PubMed  CAS  Google Scholar 

  • Da Costa D, Dritsa M, Larouche J et al (2000) Psychosocial predictors of labor/delivery complications and infant birth weight: a prospective multivariate study. J Psychosom Obstet Gynaecol 21:137–148

    Article  PubMed  Google Scholar 

  • Da Costa D, Dritsa M, Rippen N et al (2006) Health-related quality of life in postpartum depressed women. Arch Womens Ment Health 9:95–102

    Article  PubMed  Google Scholar 

  • Da Costa D, Larouche J, Dritsa M et al (1999) Variations in stress levels over the course of pregnancy: factors associated with elevated hassles, state anxiety and pregnancy-specific stress. J Psychosom Res 47:609–621

    Article  PubMed  Google Scholar 

  • Diego MA, Field T, Hernandez-Reif M et al (2004) Prepartum, postpartum, and chronic depression effects on newborns. Psychiatry 67:63–80

    PubMed  Google Scholar 

  • Dunlop DD, Manheim LM, Song J et al (2005) Incidence of disability among preretirement adults: the impact of depression. Am J Public Health 95:2003–2008

    Article  PubMed  Google Scholar 

  • Engel GL (1977) The need for a new medical model: a challenge for biomedine. Science 196:129–136

    Article  PubMed  CAS  Google Scholar 

  • Field T, Diego M, Hernandez-Reif M et al (2008) Chronic prenatal depression and neonatal outcome. Int J Neurosci 118:95–103

    Article  PubMed  Google Scholar 

  • Glynn LM, Schetter CD, Hobel CJ et al (2008) Pattern of perceived stress and anxiety in pregnancy predicts preterm birth. Health Psychol 27:43–51

    Article  PubMed  Google Scholar 

  • Haas JS, Fuentes-Afflick E, Stewart AL et al (2005) Prepregnancy health status and the risk of preterm delivery. Arch Pediatr Adolesc Med 159:58–63

    Article  PubMed  Google Scholar 

  • Haas JS, Jackson RA, Fuentes-Afflick E et al (2004) Changes in the health status of women during and after pregnancy. J Gen Intern Med 20:45–51

    Article  Google Scholar 

  • Harris B, Huckle P, Thomas R et al (1989) The use of rating scales to identify post-natal depression. Br J Psychiatry 154:813–817

    Article  PubMed  CAS  Google Scholar 

  • Hays RD, Morales LS (2001) The RAND-36 measure of health-related quality of life. Ann Med 33:350–357

    Article  PubMed  CAS  Google Scholar 

  • Hopman WM, Towheed T, Anastassiades T et al (2000) Canadian normative data for the SF-36 health survey. Can Med Assoc J 163:265–271

    CAS  Google Scholar 

  • Hueston WJ, Kasik-Miller S (1998) Changes in functional health status during normal pregnancy. J Fam Pract 47:209–212

    PubMed  CAS  Google Scholar 

  • Hurst MW, Jenkins CD, Rose RM (1978) The assessment of life change stress: a comparative and methodological inquiry. Psychosom Med 40:126–141

    PubMed  CAS  Google Scholar 

  • Jomeen J, Martin CR (2005) The factor structure of the SF-36 in early pregnancy. J Psychosom Res 59:131–138

    Article  PubMed  Google Scholar 

  • Kravitz HM, Ganz PA, Bromberger J et al (2003) Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause 10:19–28

    PubMed  Google Scholar 

  • Kuppermann M, Lubeck DP, Mazonson PD et al (1995) Sleep problems and their correlates in a working population. J Gen Intern Med 10:25–32

    Article  PubMed  CAS  Google Scholar 

  • Lacasse A, Rey E, Ferreira E et al (2008) Nausea and vomiting of pregnancy: what about quality of life? BJOG 115:1484–1493

    Article  PubMed  CAS  Google Scholar 

  • LeBlanc M, Beaulieu-Bonneau S, Merette C et al (2007) Psychological and health-related quality of life factors associated with insomnia in a population-based sample. J Psychosom Res 63:157–166

    Article  PubMed  Google Scholar 

  • Lee AM, Lam SK, Sze Mun Lau SM et al (2007) Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 110:1102–1112

    PubMed  Google Scholar 

  • Lee KA (1998) Alterations in sleep during pregnancy and postpartum: a review of 30 years of research. Sleep Med Rev 2:231–242

    Article  PubMed  CAS  Google Scholar 

  • Lee KA, Zaffke ME, McEnany G (2000) Parity and sleep patterns during and after pregnancy. Obstet Gynecol 95:14–18

    Article  PubMed  CAS  Google Scholar 

  • Leger D, Scheuermaier K, Philip P et al (2001) SF-36: evaluation of quality of life in severe and mild insomniacs compared with good sleepers. Psychosom Med 63:49–55

    PubMed  CAS  Google Scholar 

  • Li D, Liu L, Odouli R (2009) Presence of depressive symptoms during early pregnancy and the risk of preterm delivery: a prospective cohort study. Hum Reprod 24:146–153

    Article  PubMed  CAS  Google Scholar 

  • Lobel M, Cannella DL, Graham JE et al (2008) Pregnancy-specific stress, prenatal health behaviors, and birth outcomes. Health Psychol 27:604–615

    Article  PubMed  Google Scholar 

  • Manber R, Blasey C, Allen JJ (2008) Depression symptoms during pregnancy. Arch Womens Ment Health 11:43–48

    Article  PubMed  CAS  Google Scholar 

  • Mckee MD, Cunningham M, Jankowski KR et al (2001) Health-related functional status in pregnancy: relationship to depression and social support in a multi-ethnic population. Obstet Gynecol 97:988–993

    Article  PubMed  CAS  Google Scholar 

  • Murray L, Carothers AD (1990) The validation of the Edinburgh post-natal depression scale on a community sample. Br J Psychiatry 157:288–290

    Article  PubMed  CAS  Google Scholar 

  • Murray D, Cox JL (1990) Screening for depression during pregnancy with the Edinburgh Postnatal Depression Scale (EPDS). J Reprod Infant Psychol 8:99–107

    Article  Google Scholar 

  • Nicholson WK, Setse R, Hill-Briggs F et al (2006) Depressive symptoms and health-related quality of life in early pregnancy. Obstet Gynecol 107:798–806

    PubMed  Google Scholar 

  • Orr ST, Blazer DG, James SA et al (2007) Depressive symptoms and indicators of maternal health status during pregnancy. J Womens Health (Larchmt) 16:535–542

    Article  Google Scholar 

  • Otchet F, Carey MS, Adam L (1999) General health and psychological symptom status in pregnancy and the puerperium: what is normal? Obstet Gynecol 94:935–941

    Article  PubMed  CAS  Google Scholar 

  • Roesch SC, Dunkel-Schetter C, Woo G et al (2004) Modeling the types and timing of stress in pregnancy. Anxiety, Stress, and Coping: An international Journal 17:87–102

    Article  Google Scholar 

  • Santiago JR, Nolledo MS, Kinzler W et al (2001) Sleep and sleep disorders in pregnancy. Ann Intern Med 134:396–408

    PubMed  CAS  Google Scholar 

  • Setse R, Grogan R, Pham L et al (2008) Longitudinal study of depressive symptoms and health-related quality of life during pregnancy and after delivery: the health status in pregnancy (HIP) study. Matern Child Health J

  • Sherbourne CD, Stewart AL (1991) The MOS social support survey. Soc Sci Med 32:705–714

    Article  PubMed  CAS  Google Scholar 

  • Sieber S, Germann N, Barbir A et al (2006) Emotional well-being and predictors of birth-anxiety, self-efficacy, and psychosocial adaptation in healthy pregnant women. Acta Obstet Gynecol Scand 85:1200–1207

    Article  PubMed  Google Scholar 

  • Skouteris H, Germano C, Wertheim EH et al (2008) Sleep quality and depression during pregnancy: a prospective study. J Sleep Res 17:217–220

    Article  PubMed  Google Scholar 

  • Spitzer RL, Kroenke K, Williams JBW et al (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA 282:1737–1744

    Article  PubMed  CAS  Google Scholar 

  • Sprangers MA, de Regt EB, Andries F et al (2000) Which chronic conditions are associated with better or poorer quality of life? J Clin Epidemiol 53:895–907

    Article  PubMed  CAS  Google Scholar 

  • Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E et al (2004) Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiatry 19:459–463

    Article  PubMed  CAS  Google Scholar 

  • Testa MA, Simonson DC (1996) Assessment of quality-of-life outcomes. N Eng J Med 334:835–840

    Article  CAS  Google Scholar 

  • van den Brink CL, Tijhuis M, van den Bos GA et al (2005) The contribution of self-rated health and depressive symptoms to disability severity as a predictor of 10-year mortality in European elderly men. Am J Public Health 95:2029–2034

    Article  PubMed  Google Scholar 

  • Ware JE, Sherbourne CD (1992) The MOS 36-items short-form health survey (SF-36) I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  • Ware JE, Snow KK, Kosinski M et al (1993) SF-36 health survey: manual and interpretation guide. The Health Institute, Boston

    Google Scholar 

  • Wolfson AR, Crowley SJ, Anwer U et al (2003) Changes in sleep patterns and depressive symptoms in first-time mothers: last trimester to 1-year postpartum. Behav Sleep Med 1:54–67

    Article  PubMed  Google Scholar 

  • Zelkowitz P, Milet TH (1995) Screening for post-partum depression in a community sample. Can J Psychiatry 40:80–86

    PubMed  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Medicine, McGill University, Montreal, Canada

    Deborah Da Costa

  2. Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Ave West, Montreal, QC, H3A 1A2, Canada

    Deborah Da Costa, Maria Dritsa, Nancy Verreault, Caline Balaa & Jennifer Kudzman

  3. Department of Psychology, Université du Montreal a Québec, Montreal, Canada

    Nancy Verreault

  4. Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal, Canada

    Samir Khalifé

Authors
  1. Deborah Da Costa
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  2. Maria Dritsa
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  3. Nancy Verreault
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  4. Caline Balaa
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  5. Jennifer Kudzman
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  6. Samir Khalifé
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Corresponding author

Correspondence to Deborah Da Costa.

Additional information

This study was funded by an operating grant from the Canadian Institutes of Health Research (25933)

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Da Costa, D., Dritsa, M., Verreault, N. et al. Sleep problems and depressed mood negatively impact health-related quality of life during pregnancy. Arch Womens Ment Health 13, 249–257 (2010). https://doi.org/10.1007/s00737-009-0104-3

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  • DOI: https://doi.org/10.1007/s00737-009-0104-3

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