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April 20, 2026Open Access

Factors Affecting Sleep Quality in Pregnant Women During the Second Trimester and Its Association with Birth Outcomes

Key Points

The study aims to evaluate sleep quality in pregnant women during the second trimester and its association with various birth outcomes.
Evaluated sleep quality using the Pittsburgh Sleep Quality Index (PSQI) in 2210 pregnant women.
Assessed dietary quality with the Dietary Variety Score (DVS) and prenatal depression using the Edinburgh Postnatal Depression Scale (EPDS).
Performed statistical analyses including principal component analysis, stratified analysis, and binary logistic regression.
18.14% of pregnant women experienced sleep disturbances during the second trimester.
EPDS score ≥ 11, pre-pregnancy alcohol consumption, and vomiting were identified as risk factors for sleep disturbance.
Positive dietary variety (DVS ≥ 28) and regular exercise were linked to better sleep quality.
Sleep disturbances were associated with lower risks of large for gestational age and macrosomia, and a potential increased risk for preterm birth in certain groups.

Abstract

Purpose: To evaluate the sleep quality of pregnant women in mid-pregnancy in Wuhan study and analyze its association with birth outcomes in a cross-sectional study. Patients and Methods: The sleep quality of 2210 pregnant women in the second trimester from Wuhan were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Dietary quality and prenatal depression were assessed by the dietary variety score (DVS) and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Birth outcomes were retrieved from the Maternal and Child Health Information System. Principal component analysis, stratified analysis, and binary Logistic regression were used for statistical analysis. Results: Among the 2210 pregnant women, the prevalence of sleep disturbance during the second trimester was 18.14%. After adjusting for confounding factors, a EPDS score ≥ 11, pre-pregnancy alcohol consumption, and moderate to severe vomiting during pregnancy were risk factors for sleep disturbance; while a DVS score ≥ 28 points and exercise during pregnancy were protective factors for sleep disturbance. Sleep disturbance were significantly associated with a reduced risk of large for gestational age (LGA) (OR = 0.65, 95% CI: 0.45– 0.94, P = 0.023), macrosomia (OR = 0.34, 95% CI: 0.13– 0.86, P = 0.023), and a marginal association with an increased risk of preterm birth (PTB) (OR = 1.51, 95% CI: 0.97– 2.35, P = 0.065), but stratified interaction analysis showed that sleep disturbance increased the risk of PTB, low birth weight, small for gestational age and small vulnerable neonates in mothers with pre-pregnancy BMI ≥ 24 kg/m 2 or delivering a male fetus. Conclusion: Clinically, it is crucial to enhance sleep quality screening during the second trimester and provide targeted interventions for high-risk groups to improve maternal and infant outcomes. Keywords: Pittsburgh Sleep Quality Index, dietary variety score, sleep disturbance, principal component analysis

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邹丽 et al. (Wed,) studied this question.

synapsesocial.com/papers/69e5c22d03c29399140288c7 https://doi.org/https://doi.org/10.2147/nss.s573867

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