Symptom network analysis of mental health, sleep problems, and post-traumatic stress symptoms in women with high-risk pregnancy

Women with high-risk pregnancies often experience mental health problems, sleep problems, and post-traumatic stress symptoms (PTSS). Understanding the correlations among these issues is crucial for developing effective intervention measures to improve the health conditions of women with high-risk pregnancies. This study aims to explore the relationships among mental health problems, sleep problems, and PTSS. We conducted a cross-sectional survey on 270 high-risk pregnant women. The Edinburgh Postnatal Depression Scale (EPDS), the Generalized Anxiety Disorder-7 Item Scale (GAD-7), the Pittsburgh Sleep Quality Index (PSQI), and Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) were used to assess their depressive, anxious symptoms, sleep conditions, and PTSS. Network analysis methods were employed to construct a concurrent network and identify core symptoms and bridging symptoms. Network analysis revealed that in both models, the edge connecting AV6 (Try to avoid thoughts and feelings that remind you of it) and AV7 (Make an effort to avoid conversations, people, places and activities that remind you of the matter) demonstrated the strongest estimated weight. Hyperarousal-related symptoms appear to play a potentially important bridging role, while the specific highest-ranked bridge node varies across model specifications. In contrast, AV7 appears more consistently prominent across the primary and sensitivity analyses. Using network analysis, this study examined the relationships between PTSS items, sleep disturbance and mental health symptoms in high-risk pregnant women. The findings provide exploratory information regarding the conditional association structure among depressive symptoms, anxiety symptoms, sleep problems, and PTSS in women with high-risk pregnancies.