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Sleep, Anxiety, and Vitamin D Status and Risk for Peripartum Depression

  • Maternal Fetal Medicine/Biology: Original Article
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Abstract

Peripartum depression is common and carries significant morbidity and mortality. This study aimed to identify modifiable psychological and biological factors that increase the risk for peripartum depression. In a prospective cohort study, pregnant women (n = 105) completed self-report assessments of mood (Edinburgh Postnatal Depression Scale—EPDS), anxiety (Generalized Anxiety Disorder Scale—GAD), and sleep disturbances (Pittsburgh Sleep Quality Index—PSQI) and provided a blood sample at 8-to-12 and 24-to-28 weeks of gestation and 6-to-8 and 10-to-12 weeks postpartum. During the study, 33.3% (35/105) of participants met criteria for depression (EPDS ≥ 10). Women with elevated PSQI (OR: 1.17; 95% CI 1.04–1.33) or GAD (OR: 1.33; 95% CI 1.18–1.48) scores at 8–12 weeks of gestation were significantly more likely to experience elevated depressive symptoms at subsequent assessments. Women with deficient vitamin D levels (≤ 20 ng/L) were more likely to report elevated depressive symptoms at follow-up assessments, although these findings were not statistically significant (OR: 2.40; 95% CI 0.92–6.27). Participation rates for postpartum assessments were low. Depressive and anxiety symptoms, and sleep disturbances were assessed through self-report measures. Sleep, anxiety, and potentially vitamin D disturbances in early pregnancy are associated with an increase in peripartum depression. Interventions aimed at reducing sleep and anxiety disturbances and ensuring adequate levels of vitamin D in pregnancy are potential therapeutic targets to reduce risk of peripartum depression.

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Data are available to qualified researchers by request of the authors and signing of appropriate data use agreements.

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Acknowledgements

This work was supported by the following grants: 1) K12HD055885, Building Interdisciplinary Research Careers in Women’s Health career development award; 2) UL1 TR000062, South Carolina Clinical and Translational Research Institute Pilot Grant Program; and 3) 1K23DA039318-01 career development award from the National Institute on Drug Abuse. Funding agencies were not involved in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Authors CG and RN designed the study and wrote the protocol. Material preparation, literature searches, data collection and analyses were performed by authors CG, CK, AW and CW. Original draft preparation was performed by CG. Review and editing were performed by CK. All authors contributed to and have approved the final manuscript. We would like to acknowledge and thank the women taking part in this research. Without their efforts, this study would not be possible.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences & Obstetrics and Gynecology, Medical University of South Carolina, 67 President Street, Charleston, SC, 29425, USA

    Courtney E. King, Allison Wilkerson & Constance Guille

  2. Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA

    Roger Newman & Constance Guille

  3. Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA

    Carol L. Wagner

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  1. Courtney E. King
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Correspondence to Constance Guille.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board at the Medical University of South Carolina (MUSC) (Protocol Number 00011507).

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All study participants gave their informed consent prior to inclusion in the study.

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King, C.E., Wilkerson, A., Newman, R. et al. Sleep, Anxiety, and Vitamin D Status and Risk for Peripartum Depression. Reprod. Sci. 29, 1851–1858 (2022). https://doi.org/10.1007/s43032-022-00922-1

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