Do changes in subjective sleep and biological rhythms predict worsening in postpartum depressive symptoms? A prospective study across the perinatal period

Feb 28, 2016Archives of women's mental health

Can changes in sleep and body rhythms predict worsening depression after childbirth? A study during pregnancy and after birth

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Abstract

Eighty-three participants were studied to evaluate the relationship between sleep and biological rhythm changes and depressive symptoms during the perinatal period.

Changes in biological rhythms during the perinatal period predicted worsening depressive symptoms in both women with and without a history of mood disorders.
Women with a history of mood disorders experienced higher levels of sleep and biological rhythm disruption during pregnancy and postpartum.
Subjective assessments were utilized to measure sleep quality, biological rhythm disturbances, and depressive symptoms at two time points: third trimester and 6-12 weeks postpartum.

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Abnormalities of sleep and biological rhythms have been widely implicated in the pathophysiology of major depressive disorder (MDD) and bipolar disorder (BD). However, less is known about the influence of biological rhythm disruptions across the perinatal period on postpartum depression (PPD). The objective of this study was to prospectively evaluate the relationship between subjective changes in both sleep and biological rhythms and worsening of depressive symptoms from pregnancy to the postpartum period in women with and without mood disorders. Eighty-three participants (38 euthymic women with a history of a mood disorder and 45 healthy controls) were studied. Participants completed subjective assessments of sleep (Pittsburgh Sleep Quality Index), biological rhythm disturbances (Biological Rhythms Interview of Assessment in Neuropsychiatry), and depressive symptoms (Edinburgh Postnatal Depression Scale) prospectively at two time points: third trimester of pregnancy and at 6-12 weeks postpartum. Multivariate regression analyses showed that changes in biological rhythms across the perinatal period predicted worsening of depressive symptoms in both groups. Moreover, women with a history of a mood disorder showed higher levels of sleep and biological rhythm disruption during both pregnancy and the postpartum period. These findings suggest that disruptions in biological rhythms during the perinatal period increase the risk for postpartum mood worsening in healthy pregnant as well as in pregnant women with a history of mood disorders.

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Do changes in subjective sleep and biological rhythms predict worsening in postpartum depressive symptoms? A prospective study across the perinatal period

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