Association between insomnia during pregnancy and postpartum depression, a cohort study from Kurunegala district, Sri Lanka

Abstract

Insomnia during the antenatal period could have long-term impacts including postpartum depression. Healthcare providers should pay more attention to psychological and emotional needs during pregnancy, to make women feel safe, comfortable, and positive about the experience. This study aims to determine the association between antenatal insomnia and postpartum depression. A prospective cohort study was conducted among 843 pregnant women in Kurunegala district, Sri Lanka. The sample was identified by using the multi-stage cluster sampling method. Three self-administered questionnaires were used including a socio-demographic characteristic questionnaire: the Edinburgh postnatal depression scale (EPDS) and the Pittsburgh Sleep Quality Index (PSQI). The mean age of the study participants was 29.2±5.3 years and including the newborns, each study participant had 0 to 5 children. In the study sample, 44.4% (n=374) were primipara. Insomnia was seen among 66.4% (n=587) of study participants during the third trimester of pregnancy. The mean global PSQI was 7.19 [SD – 3.595, 95%CI- 6.95; 7.43, SE- .124]. The prevalence of depression defined as an EPDS more than or equal to 9 was 28.8% (n=255) in the fourth week of the postpartum period. The mean EPDS score was 6.11[SD 5.107, 95%CI 5.76; 6.45]. There was a significant association between the Edinburgh postnatal depression scale score and the Pittsburgh sleep quality index score (p<0.001). There is a high prevalence of insomnia during the third trimester of pregnancy. Furthermore, there is a significant association between insomnia during pregnancy and postpartum depression.