Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort study
Abstract Background Perinatal insomnia and depression significantly impact maternal-infant health, but their co-developing trajectories are poorly understood. This study examines their heterogeneous progression, interrelationships, and predictive factors across the perinatal period. Methods This was...
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2025-05-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07649-2 |
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| author | Xinlong Pan Yang Chen Chunli Chen Jianfei Chen Jiarun Wang Yujia Chen Wei Zhang Jiaxin Wu Wenhui Liu Zhijie Zou Luyang Zhu Xiaoli Chen |
| author_facet | Xinlong Pan Yang Chen Chunli Chen Jianfei Chen Jiarun Wang Yujia Chen Wei Zhang Jiaxin Wu Wenhui Liu Zhijie Zou Luyang Zhu Xiaoli Chen |
| author_sort | Xinlong Pan |
| collection | DOAJ |
| description | Abstract Background Perinatal insomnia and depression significantly impact maternal-infant health, but their co-developing trajectories are poorly understood. This study examines their heterogeneous progression, interrelationships, and predictive factors across the perinatal period. Methods This was part of a mother-infant cohort study conducted in the obstetrics outpatient clinic of a tertiary hospital in Wuhan, Hubei Province. Pregnant women were enrolled (N = 1034) at early pregnancy (< 14 weeks) from July 2022 to September 2023. The perinatal depressive symptoms, insomnia severity, anxiety symptoms, and social capital were reassessed at 5-time points from enrollment (T0) to 6 months postpartum using the Edinburgh postnatal depression scale, the Insomnia Severity Index, the Pregnancy-related Anxiety Questionnaire, and the Personal Social Capital Scale 16, respectively. The follow-up time points were 16–20 weeks of gestation (T1), 28–36 weeks of gestation (T2), six weeks postpartum (T3) and six months postpartum (T4), respectively. Group-based trajectory modelling and binary logistic regression modelling were used to analyze the data (n = 436). Results We identified three trajectories for perinatal insomnia and depression symptoms. Insomnia: no insomnia (27.7%), subclinical (54.5%), clinical (17.8%). Depression: low-stable (38.7%), moderate-stable (43.9%), high-improving (17.4%). The dual trajectory analysis revealed significant co-occurrence patterns between insomnia and depression trajectories (p < 0.001). Members of the high-improving depression group were more likely to have clinical insomnia trajectories. Baseline ISI ≥ 8, EPDS ≥ 10, and PRAQ ≥ 24 predicted the higher trajectories of perinatal insomnia and depressive symptoms (all p < 0.05). Conclusions Perinatal insomnia and depression follow three distinct but interrelated trajectories, identifiable through early screening. Risk-stratified interventions should consider their co-occurrence patterns to optimize outcomes. |
| format | Article |
| id | doaj-art-a8346436be4e429ab5b4d58c8a620145 |
| institution | Kabale University |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-a8346436be4e429ab5b4d58c8a6201452025-08-20T03:53:57ZengBMCBMC Pregnancy and Childbirth1471-23932025-05-0125111310.1186/s12884-025-07649-2Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort studyXinlong Pan0Yang Chen1Chunli Chen2Jianfei Chen3Jiarun Wang4Yujia Chen5Wei Zhang6Jiaxin Wu7Wenhui Liu8Zhijie Zou9Luyang Zhu10Xiaoli Chen11School of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversityDepartment of Obstetrics, Renmin Hospital of Wuhan UniversitySchool of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversityGuangzhou Huanan Business CollegeDepartment of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan UniversitySchool of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversitySchool of Nursing, Wuhan UniversityAbstract Background Perinatal insomnia and depression significantly impact maternal-infant health, but their co-developing trajectories are poorly understood. This study examines their heterogeneous progression, interrelationships, and predictive factors across the perinatal period. Methods This was part of a mother-infant cohort study conducted in the obstetrics outpatient clinic of a tertiary hospital in Wuhan, Hubei Province. Pregnant women were enrolled (N = 1034) at early pregnancy (< 14 weeks) from July 2022 to September 2023. The perinatal depressive symptoms, insomnia severity, anxiety symptoms, and social capital were reassessed at 5-time points from enrollment (T0) to 6 months postpartum using the Edinburgh postnatal depression scale, the Insomnia Severity Index, the Pregnancy-related Anxiety Questionnaire, and the Personal Social Capital Scale 16, respectively. The follow-up time points were 16–20 weeks of gestation (T1), 28–36 weeks of gestation (T2), six weeks postpartum (T3) and six months postpartum (T4), respectively. Group-based trajectory modelling and binary logistic regression modelling were used to analyze the data (n = 436). Results We identified three trajectories for perinatal insomnia and depression symptoms. Insomnia: no insomnia (27.7%), subclinical (54.5%), clinical (17.8%). Depression: low-stable (38.7%), moderate-stable (43.9%), high-improving (17.4%). The dual trajectory analysis revealed significant co-occurrence patterns between insomnia and depression trajectories (p < 0.001). Members of the high-improving depression group were more likely to have clinical insomnia trajectories. Baseline ISI ≥ 8, EPDS ≥ 10, and PRAQ ≥ 24 predicted the higher trajectories of perinatal insomnia and depressive symptoms (all p < 0.05). Conclusions Perinatal insomnia and depression follow three distinct but interrelated trajectories, identifiable through early screening. Risk-stratified interventions should consider their co-occurrence patterns to optimize outcomes.https://doi.org/10.1186/s12884-025-07649-2Dual trajectoryGroup-based trajectoryInsomniaPerinatal depressionSocial capital |
| spellingShingle | Xinlong Pan Yang Chen Chunli Chen Jianfei Chen Jiarun Wang Yujia Chen Wei Zhang Jiaxin Wu Wenhui Liu Zhijie Zou Luyang Zhu Xiaoli Chen Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort study BMC Pregnancy and Childbirth Dual trajectory Group-based trajectory Insomnia Perinatal depression Social capital |
| title | Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort study |
| title_full | Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort study |
| title_fullStr | Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort study |
| title_full_unstemmed | Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort study |
| title_short | Dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum: a prospective cohort study |
| title_sort | dual trajectory of insomnia and depressive symptoms in women from early pregnancy to 6 months postpartum a prospective cohort study |
| topic | Dual trajectory Group-based trajectory Insomnia Perinatal depression Social capital |
| url | https://doi.org/10.1186/s12884-025-07649-2 |
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