UCSF

The purpose of this study was to describe depressive symptoms and sleep in first-time mothers. Predictors of postpartum depressive symptoms, including perceived stress, social support, and maternal adjustment were also examined. Another purpose was to compare objective and subjective sleep in mothers with and without depressive symptoms in the third trimester (Time 1) and at 12 weeks postpartum (Time 2).

This descriptive, correlational, longitudinal, secondary analysis utilized data from two randomized clinical trials. Depressive symptoms, psychosocial measures, and subjective and objective sleep measures were collected on a sample of 161 first-time mothers between the ages of 18 and 43 years.

The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms. Mean CES-D scores at Time 1 (12.2 ± 7.0) significantly improved at Time 2 (8.8 ± 6.7). However, of the 46 women scoring in the depressed range at Time 1, 32.6 % (n = 15) continued to experience depressive symptoms at 12 weeks postpartum. Of the 115 women with minimal symptoms at Time 1, 7% (n = 8) experienced depressive symptoms at 12 weeks postpartum. Depressive symptoms and sleep disturbance were significantly associated at Time 1 and Time 2. Overall sleep disturbance, minutes to fall asleep, ability to stay asleep, and daytime sleepiness significantly improved from late pregnancy to 12 weeks postpartum. Women with depressive symptoms in the late third trimester and 12 weeks postpartum reported significantly more sleep disturbance, trouble falling asleep and more daytime sleepiness than women without depressive symptoms. Fifty-seven percent of the variance in mothers' depressive symptoms at 12 weeks postpartum was explained by six independent variables. However, antenatal CES-D score alone was a significant predictor of postpartum depression scores, accounting for 16.7% of the variance in depression scores at 12 weeks postpartum.

The results of this study underscore the need for health care providers to assess depressive symptoms and sleep during pregnancy and during the first few postpartum months. Furthermore, results suggest that complaints of sleep disturbance, especially prolonged sleep onset latency and increased daytime sleepiness, may be relevant screening questions in relation to risk for postpartum depression.