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S085-5

The Relationship Between Sleep Quality and Depression During Pregnancy

Shi Hui Poon1, Tze-Ern Chua2, Helen Chen2

1Singapore General Hospital, Singapore2KK Women's and Children's Hospital, Singapore 2KK Women's and
Children's Hospital, Singapore

Background/Objective: Poor sleep and depression are both common problems during pregnancy,
but there has been little investigation into the association between them, particularly in the local
population. This prospective study aims to examine the relationship between sleep quality and
depression during pregnancy.

Method: Pregnant women under 14 weeks’ gestation attending outpatient antenatal care in
Singapore’s largest maternity hospital were recruited between August 2012 and April 2014. Women
with multiple pregnancies and deemed at high risk of miscarriage were excluded. Participants
completed the Pittsburgh Sleep Quality Index (PSQI) and Edinburgh Postnatal Depression Scale
(EPDS) at three time points during pregnancy: 11 – 14, 18 – 22 and 28 – 32 gestational weeks.

Result: PSQI and EPDS scores of 640 women obtained at three time-points were analyzed. Analysis
shows the mean PSQI score was highest in the third visit, suggesting poorer-quality sleep in the late
third trimester compared to the other time points. The mean (± SD) PSQI scores in each of the visits
were 6.05 + 3.00, 5.79 + 3.11 and 6.57 + 3.12 (p <0.001) respectively.

The mean EPDS score was highest in the first trimester and lower at other time points.
Corresponding mean EPDS scores in the three visits were 7.62 + 4.56, 7.00 + 4.77 and 7.22 + 4.89 (p
<0.001). 15.7% of participants at each time point fulfilled the criteria for antenatal depression
according to the EPDS cut-off score of >14. PSQI scores were significantly correlated with EPDS
scores in each of the three trimesters. Poor sleep quality in pregnancy prospectively predicted the
development of depressive symptoms.

Conclusion: Sleep quality in Singaporean pregnant women was poorest in the third trimester, and
also predicted the development of depressive symptoms. With more than one in ten women having
antenatal depression, Interventions targeting sleep quality might be particularly beneficial.