Sleep medicine · 2026
Sleep-disordered breathing during pregnancy and the risk of postpartum depression.
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Yakefu Alimire, Ni Yue-Nan, Thomas Robert Joseph
Аннотация
BACKGROUND: Sleep-disordered breathing, mostly obstructive sleep apnea (OSA), is prevalent during pregnancy, but its association with postpartum depression (PPD) remains poorly understood.
OBJECTIVE: To prospectively investigate the relationship between apnea-hypopnea index (AHI) and other OSA metrics including oxygen desaturation index (ODI), minimum oxygen saturation (MinSpO2), and hypoxic burden (HB), measured in early and mid-pregnancy, and the risk of developing PPD.
METHODS: A secondary analysis of the Sleep-Disordered Breathing substudy within the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b). Objective home sleep apnea testing was performed during early and mid-pregnancy to obtain AHI, oxygen desaturation index (ODI), MinSpO2 and hypoxic burden (HB). PPD was assessed at 4-12 weeks using the Edinburgh Postnatal Depression Scale. Separate multivariate logistic regression models, adjusted for covariates including pre-pregnancy depression history and BMI, were constructed to analyze the associations of early and mid-pregnancy sleep metrics with PPD.
RESULTS: This study included 2888 and 2292 participants with complete data from early and mid-pregnancy, respectively. The prevalence of probable PPD was 4.22% (n = 122) in the early and 4.32% (n = 99) in the mid-pregnancy cohorts, respectively. In early pregnancy, AHI was not a significant predictor (p: 0.810); nor were ODI (p: 0.867) or HB (p: 0.909). Exploratory analysis of MinSpO2 showed an independent association with PPD risk (adjusted OR = 0.887, 95% CI 0.818-0.961, p: 0.003). In mid-pregnancy, AHI emerged as a significant predictor of PPD (adjusted OR = 1.024, 95% CI: 1.001-1.047, p: 0.042), whereas ODI (p: 0.628), MinSpO2 (p: 0.798), and HB (p: 0.863) were not retained in the final model. A history of depression prior to pregnancy was the most robust risk factor across all models.
CONCLUSION: This study demonstrates a significant association between sleep-disordered breathing during pregnancy and an increased risk of postpartum depression.
OBJECTIVE: To prospectively investigate the relationship between apnea-hypopnea index (AHI) and other OSA metrics including oxygen desaturation index (ODI), minimum oxygen saturation (MinSpO2), and hypoxic burden (HB), measured in early and mid-pregnancy, and the risk of developing PPD.
METHODS: A secondary analysis of the Sleep-Disordered Breathing substudy within the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b). Objective home sleep apnea testing was performed during early and mid-pregnancy to obtain AHI, oxygen desaturation index (ODI), MinSpO2 and hypoxic burden (HB). PPD was assessed at 4-12 weeks using the Edinburgh Postnatal Depression Scale. Separate multivariate logistic regression models, adjusted for covariates including pre-pregnancy depression history and BMI, were constructed to analyze the associations of early and mid-pregnancy sleep metrics with PPD.
RESULTS: This study included 2888 and 2292 participants with complete data from early and mid-pregnancy, respectively. The prevalence of probable PPD was 4.22% (n = 122) in the early and 4.32% (n = 99) in the mid-pregnancy cohorts, respectively. In early pregnancy, AHI was not a significant predictor (p: 0.810); nor were ODI (p: 0.867) or HB (p: 0.909). Exploratory analysis of MinSpO2 showed an independent association with PPD risk (adjusted OR = 0.887, 95% CI 0.818-0.961, p: 0.003). In mid-pregnancy, AHI emerged as a significant predictor of PPD (adjusted OR = 1.024, 95% CI: 1.001-1.047, p: 0.042), whereas ODI (p: 0.628), MinSpO2 (p: 0.798), and HB (p: 0.863) were not retained in the final model. A history of depression prior to pregnancy was the most robust risk factor across all models.
CONCLUSION: This study demonstrates a significant association between sleep-disordered breathing during pregnancy and an increased risk of postpartum depression.