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Psychiatry Investig. 2019 May;16(5):363-369. doi: 10.30773/pi.2019.02.14. Epub 2019 May 23.

Relations between Stress and Quality of Life among Women in Late Pregnancy: The Parallel Mediating Role of Depressive Symptoms and Sleep Quality.

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Department of Social Medicine, School of Public Health, Jilin University, Changchun, China.
Department of Nursing Management, School of Nursing, Jilin University, Changchun, China.
Department of Maternal and Child Health, School of Public Health, Jilin University, Changchun, China.



This study aims to examine the parallel multiple mediators of depressive symptoms and sleep quality in the relations between stress and physical health-related quality of life (PHQOL)/mental health-related quality of life (MHQOL) among the women in late pregnancy.


Of 1120 pregnant women participated in the cross-sectional study which consisted of Perceived Stress Scale, Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index and MOS 12-item Short Form Health Survey. Parallel multiple mediator models were used to analyze the relations between stress, depressive symptoms, sleep quality and PHQOL/MHQOL.


The effect of perceived stress on PHQOL was partially through the indirect path of sleep quality (β=-0.061). But in the model for MHQOL, depressive symptoms and sleep quality played parallel mediators, and the indirect path effect of depressive symptoms (β=-0.179) was higher than sleep quality (β=-0.029).


The findings contributed to the understanding about the influential mechanism of stress on PHQOL/MHQOL. And it reminded the importance of sleep quality and depressive symptoms for improving QOL in late pregnancy.


Depression; Mechanism; Parallel multiple mediation model; Pregnant woman; Quality of life; Sleep quality

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