1038 Sleep Health Dimensions and Perceived Stress in African American Pregnant Women

Abstract Introduction African American pregnant women (AAPW) experience disproportionately high levels of stress. Poor sleep health has been linked to heightened stress, which can contribute to adverse maternal-fetal outcomes, including impaired glucose levels, preterm birth, low birth weight, and postpartum depression. This study investigates the relationship between individual sleep health dimensions, multidimensional sleep health (MSH), and perceived stress during early pregnancy in AAPW. Methods Data from 76 AAPW enrolled in the BETTER lifestyle counseling study (NCT05234125) were analyzed. Sleep health was assessed using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, subjective alertness ratings (0–100), and Fitbit-derived measures, including sleep duration, efficiency, timing (sleep midpoint), and regularity (standard deviation of sleep midpoint). Perceived stress was measured using the Perceived Stress Scale (PSS). A composite MSH score was calculated as the sum of "good" individual sleep health dimensions. Multiple regression analyses were conducted to examine whether individual sleep dimensions and MSH scores independently predicted perceived stress levels in AAPW. Results Participants had a mean age of 29.79 years (SD=5.31), mean gestational age of 18.19 weeks (SD=2.77), and mean BMI of 33.12 kg/m² (SD=4.98). After adjusting for covariates, poor sleep quality (β=0.48, p=0.007, 95% CI: 0.134, 0.831) and lower alertness (β=-0.08, p=0.004, 95% CI: -0.133, -0.026) were significantly associated with higher perceived stress levels. However, MSH was not significantly associated with perceived stress, either with (β=-0.39, p=0.467, 95% CI: -1.471, 0.683) or without adjustment for covariates. Conclusion Sleep quality and alertness were significantly associated with perceived stress in AAPW, highlighting the importance of comprehensive sleep health evaluation during pregnancy. Future research should explore the longitudinal relationships between sleep health dimensions and stress throughout pregnancy, as well as investigate potential mechanisms underlying these associations. Support (if any) This study is funded by the NIH/NIMHD R01MD015724