Sleep heterogeneity in the third trimester of pregnancy: Correlations with depression, memory impairment, and fatigue

Relationship Between Sleep Problems and Memory Impairment Among Nurses

BACKGROUND

Sleep problems are common among nurses and can lead to various health problems. Further, the relationship between multiple sleep problems and memory impairment in clinical nurses remains unknown. Therefore, in this study, we aimed to explore the relationship between sleep problems and memory impairment among nurses.

METHODS

Multistage cluster-stratified random sampling was performed from tertiary hospitals in Shandong, China. Overall, a total of 1833 nurses were included in the final analysis. The Chinese version of the Pittsburgh Sleep Quality Index and prospective and retrospective memory questionnaire were administered to the participants.

RESULTS

The sleep quality of the nurses decreased during the normal epidemic prevention and control period compared with that before the epidemic in terms of sleep duration, sleep efficiency, and sleep disturbances. Nurses who reported cumulative or specific sleep problems (e.g., high sleep latency, sleep disturbances, and daytime dysfunction) and those in the "daily disturbances" and "poor sleep quality" groups had a higher risk of memory impairment than the others.

CONCLUSION

Sleep problems might be important for memory impairment among nurses. These findings may help identify nurses at considerable risk of memory impairment in clinical practice.

Fear of childbirth and sleep quality among pregnant women: a generalized additive model and moderated mediation analysis

OBJECTIVES

This study aims to examine the associations among fear of childbirth, psychological distress, resilience, and sleep quality among Chinese pregnant women.

METHODS

A cross-sectional survey was carried out between January 2022 to March 2022 among pregnant women who met the inclusion criteria and sought healthcare services at The First Affiliated Hospital of Guangzhou University of Chinese Medicine in Guangdong Province, Southern China. Data was collected using a structured questionnaire that included sociodemographic characteristics, childbirth attitudes questionnaires (CAQ), hospital anxiety and depression scale (HADS), Connor-Davidson resilience scale (CD-RISC), and Pittsburgh sleep quality index (PSQI). A generalized additive model and moderated mediation analysis were employed for data analysis.

RESULTS

A non-linear and negative association between fear of childbirth and sleep quality was found in the second trimester and antenatal period. Psychological distress significantly mediated the relationship between fear of childbirth and sleep quality (first trimester: β = 0.044, 95%CI:0.022-0.071; second trimester: β = 0.029, 95%CI:0.009-0.056; third trimester: β = 0.064, 95%CI:0.046-0.088; antenatal period: β = 0.050, 95%CI:0.037-0.063). The moderating role of resilience between fear of childbirth and sleep quality was significant (second trimester: β=-0.006, 95%CI:-0.012-0.001, P = 0.025; antenatal period: β=-0.004, 95%CI:-0.007--0.001, P = 0.014), as well as between fear of childbirth and psychological distress (first trimester: β=-0.016, 95%CI:-0.026--0.005, P = 0.004; antenatal period: β=-0.005, 95%CI:-0.009--0.001, P = 0.014).

CONCLUSIONS

Fear of childbirth, psychological distress, and resilience are three important factors affecting sleep quality in Chinese pregnant women.

Risk factors of positive depression screening during the third trimester of pregnancy in a Chinese tertiary hospital: a cross-sectional study

OBJECTIVE

Pregnant women experience enormous psychological pressure, particularly during the late trimester. Symptoms of depression in late pregnancy may persist postpartum, increasing the incidence of postpartum depression. This study is aimed to investigate the factors influencing depressive symptoms among pregnant women in their third trimester at a Chinese tertiary hospital and provide information for effective intervention.

METHODS

Pregnant women in their third trimester who visited the Ningbo Women and Children's Hospital between January 1, 2020 and June 30, 2022 participated in this study. A score of ≥ 13 on the Edinburgh Postnatal Depression Scale (EPDS) was considered as positive for depressive symptom. Potential influencing factors were examined by using an online questionnaire and analyzed using multivariate logistic regression.

RESULTS

A total of 1196 participants were recruited. The mean EPDS score was 7.12 ± 4.22. The positive screening rate for depressive symptom was 9.9%. Univariate analysis showed that living with partner, annual family income, planned pregnancy, sleep quality, and partner's drinking habits were related to positive screening for depression(P < 0.05). Furthermore, multivariate logistic regression analysis showed that living away from the partner (odds ratio [OR]: 2.054, 95% confidence interval [CI]: 1.094-3.696, P = 0.02), annual family income < 150,000 Chinese Yuan (CNY; OR: 1.762, 95% CI: 1.170-2.678, P = 0.007), poor sleep quality (OR: 4.123, 95% CI: 2.764-6.163, P < 0.001), and partner's frequent drinking habit (OR: 2.227, 95% CI: 1.129-4.323, P = 0.019) were independent influencing factors for positive depression screening (P < 0.05).

CONCLUSION

Family's economic condition, sleep quality, living with partner, and partner's drinking habits were related to positive depression screening in late pregnancy. Pregnant women with these risk factors should be given more attention and supported to avoid developing depression.

The effects of reflexology on symptoms in pregnancy: A systematic review of randomized controlled trials

Objective

This review assessed the effects of reflexology on symptoms in pregnancy.

Methods and analysis

PubMed, Embase, Springer, Web of Science, the Cochrane Library, and reference lists of previous systematic reviews were searched for the eligible randomized controlled trials (RCT) from the inception date of each predefined database up to May 31st, 2023. Data were extracted, and methodological quality was evaluated by the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2). The efficacy of treatment was assessed using pooled effect sizes (Hedges' g) and 95% confidence intervals (CI). Meta-analysis was performed using the RevMan 5.4 manager, and publication bias was evaluated by Begg's test.

Results

The included a total of 13 RCTs in this review, of eleven was high risk of bias and two were low, reported the effects of reflexology on low back and/or pelvic pain (LBPP), labor pain, duration of labor, anxiety, fatigue, sleep quality, constipation symptoms, and ankle and foot edema in pregnancy. The effect sizes (Hedges' g) for reflexology in labor pain, duration of labor, anxiety, fatigue, and sleep quality showed statistical significance, which the meta-analysis also confirmed except for fatigue and sleep quality due to insufficient studies.

Conclusion

Reflexology is probably effective and safe for labor pain, duration of labor, and anxiety in pregnancy, while the evidences for reflexology in LBPP, fatigue, sleep quality, constipation symptoms, and ankle and foot edema during pregnancy were insufficient. Based on the low to high quality of included studies, strong supportive evidence is not yet available. Rigorous-design and large-scale clinical trials should be conducted to provide higher-quality, reliable evidence.

A longitudinal study of perinatal depression and the risk role of cognitive fusion and perceived stress on postpartum depression

AIMS AND OBJECTIVES

To explore fluctuations in perinatal depression based on physiological, psychological and interpersonal dimensions to analyse risk factors across three time points: in the third trimester and at weeks 1 and 6 postpartum.

BACKGROUND

Pregnant women experience depression at multiple time points and require screening. Studies have shown protective and negative factors related to postpartum depression. Cognitive fusion refers to an individual's emotions and behaviours that are regulated and influenced by that individual's own cognitive overregulation, especially when facing stress. This is an important psychological factor related to depression, but little is known about it in pregnant women.

DESIGN

A longitudinal study was conducted from June 2019-July 2020, and the findings are reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

METHODS

Pregnant women (n = 207) were recruited, and a questionnaire survey was performed at 32-34 weeks of pregnancy and at weeks 1 and 6 postpartum. Repeated-measures analysis of variance was performed to analyse the changes in depression over time. Regression analysis and linear mixed modelling were used to identify risk factors. Pearson's correlation analysis was performed to analyse the relationships between variables.

RESULTS

Of the pregnant women, 36.70% experienced antenatal depression and prolonged depression with the onset of postpartum depression (12.21%). Some depressive moods disappeared spontaneously after delivery (47.37%). Perceived stress was the highest risk predictor of postpartum depression (β = 0.332), followed by cognitive fusion (β = 0.178), which remained stable over time and might have been positively related to having a vulnerable personality (0.2 < r < 0.4). Social support plays a positive role in lowering postpartum depression (β = -0.027).

CONCLUSIONS

Changes in depression were influenced by multiple factors with stability and predictability across time. Psychological dimensions, such as perceived stress and cognitive fusion, are risk factors for developing postpartum depression and antenatal depression.

RELEVANCE TO CLINICAL PRACTICE

Pregnant women can be divided into depressive cohorts according to screening at different time points to provide targeted interventions.

Effects of Pregnant Fatigue on the Development of Offspring in Rats

AIM

To explore the correlation between pregnant fatigue and intrauterine physical and neural development of offspring in rats.

METHODS

Sprague-Dawley pregnant rats were randomly divided into a normal control group, a mild fatigue group (stand in water for 6 hours/day), and a severe fatigue group (stand in water for 15 h/day). The levels of lactic acid, 5-Hydroxytryptamine and Interleukin-6 in cardiac serum of rats were used to evaluate the fatigue. The expression of S100β in the telencephalon, Insulin-like growth factor-1 (IGF-1) in the liver and Cyclooxygenage-2 (COX-2) in the small intestine tissues of fetal rats were examined. Frozen sections were taken from the telencephalon of rat pups to observe morphological changes in the hippocampal primordium.

RESULTS

Pregnant fatigue led to a decrease in food intake (F = 37.586, p = 0.000) and water intake (F = 23.608, p = 0.000) in rats. The IGF-1 mRNA expression of fetal rats in the severe fatigue group was lower than that in the control group (p = 0.0003). The expression of S100β mRNA (p = 0.000) and COX-2 mRNA (p = 0.0002) of fetal rats were higher in the severe fatigue group than in the control group. HE staining of the telencephalon of fetal rats in the pregnant fatigue group revealed sparse and irregular cell arrangement and increased gaps in the hippocampal primordial site.

CONCLUSION

Pregnant fatigue rats had both physical fatigue and mental fatigue. Fatigue during pregnancy affects physical development and neurodevelopment of offspring. Further research should elucidate the mechanisms of pregnant fatigue and its effects on offspring.

Repetitive negative thinking in the perinatal period and its relationship with anxiety and depression

BACKGROUND

Rumination and worry represent two types of repetitive negative thinking (RNT), and their predictive and maintaining roles are well-established in depression and anxiety, respectively. Furthermore, there is an emerging literature on the link between RNT and psychological wellbeing in the perinatal period.

METHODS

We conducted a scoping review of studies that have investigated the relationship between RNT and perinatal depression and anxiety. We identified 87 papers eligible for inclusion in the review; they included cross-sectional and longitudinal studies, as well as treatment evaluations (pilot trials and randomised controlled trials).

RESULTS

Cross-sectional studies provided evidence of an association between RNT (i.e., rumination and worry) and depression and anxiety, in both pregnancy and postpartum. Longitudinal findings were mixed. Whilst antenatal worry consistently predicted subsequent depression and anxiety (both later in pregnancy and postpartum), rumination did not consistently predict depression. However, there was some evidence that rumination interacted with other processes to predict later psychopathology. Three randomised controlled trials evaluated whether psychological treatments reduce RNT in the perinatal period, only one of which included a clinical sample.

LIMITATIONS

No experimental investigations were eligible for inclusion in the review.

CONCLUSIONS

Further studies are needed to further our understanding of the nature and role of RNT in pregnancy and postpartum, and its consequences for maternal mental health. These include (but are not limited to) experimental investigations, studies with large clinical samples, and RCTs evaluating the effectiveness of psychological interventions targeting RNT to prevent and treat perinatal depression and anxiety.

Sex Hormones, Sleep, and Memory: Interrelationships Across the Adult Female Lifespan

As the population of older adults grows, so will the prevalence of aging-related conditions, including memory impairments and sleep disturbances, both of which are more common among women. Compared to older men, older women are up to twice as likely to experience sleep disturbances and are at a higher risk of cognitive decline and Alzheimer's disease and related dementias (ADRD). These sex differences may be attributed in part to fluctuations in levels of female sex hormones (i.e., estrogen and progesterone) that occur across the adult female lifespan. Though women tend to experience the most significant sleep and memory problems during the peri-menopausal period, changes in memory and sleep have also been observed across the menstrual cycle and during pregnancy. Here, we review current knowledge on the interrelationships among female sex hormones, sleep, and memory across the female lifespan, propose possible mediating and moderating mechanisms linking these variables and describe implications for ADRD risk in later life.