Sleep disorders during pregnancy and postpartum depression: A systematic review and meta-analysis

Abstract

BACKGROUND: Postpartum depression (PPD) is one of the most important mental disorders in recent years. However, the effects of prenatal sleep disorders on the development of PPD among pregnant women have not been elucidated. This review aims to provide a summary of the literature evaluating the relation between sleep disorders during pregnancy and PPD. METHOD: A systematic literature search was conducted in PubMed, Web of Science, Scopus, Google Scholar, and Embase up to September 2020. All observational studies (cross-sectional, case-control, and cohort) and studies that assessed the association between sleep disorders during pregnancy and PPD were included. Total sample of 36,873 women from 13 studies was entered to meta-analysis. An aggregate effect size estimate (odds ratio) was generated using the comprehensive meta-analysis software. A random effects model was set a priori. Heterogeneity and publication bias were examined using the standard meta-analytic approaches. RESULT: We found maternal sleep disorder increased odds of PPD (point estimate, 3.300; 95 confidence interval CI, 2.136-5.098; p < .001; n = 13). However, there was significant heterogeneity (Q, 131.250; df, 12; p < .001; I(2) , 90.857%). The estimated effect size was significant for all categorical studies. According to meta-regression, no moderating factor (age and publication year) significantly mediated the estimated effect size. CONCLUSION: We found a significant relationship between sleep disturbances during pregnancy and PPD. Women with sleep disorders are at an increased risk of developing PPD, which warrants screening pregnant mothers for sleep disturbances. Also, we found that the increasing age in pregnancy was associated with increased risk of PPD.