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Gen Hosp Psychiatry. 2015 Sep-Oct;37(5):441-7. doi: 10.1016/j.genhosppsych.2015.04.014. Epub 2015 May 6.

Association of poor subjective sleep quality with suicidal ideation among pregnant Peruvian women.

Author information

1
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. Electronic address: bgelaye@hsph.harvard.edu.
2
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
3
Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru.
4
Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
5
Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Asociación Civil PROESA, Lima, Peru.
6
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Abstract

OBJECTIVE:

To examine the independent and joint relationships of poor subjective sleep quality and antepartum depression with suicidal ideation among pregnant women.

METHODS:

A cross-sectional study was conducted among 641 pregnant women attending prenatal care clinics in Lima, Peru. Antepartum depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 scale. Antepartum subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression procedures were performed to estimate odds ratios (aOR) and 95% confidence intervals (95% CI) adjusted for confounders.

RESULTS:

Overall, the prevalence of suicidal ideation in this cohort was 16.8% and poor subjective sleep quality was more common among women endorsing suicidal ideation as compared to their counterparts who did not (47.2% vs. 24.8%, P<.001). After adjustment for confounders including maternal depression, poor subjective sleep quality (defined using the recommended criteria of PSQI global score of >5 vs. ≤5) was associated with a 1.7-fold increased odds of suicidal ideation (aOR=1.67; 95% CI 1.02-2.71). When assessed as a continuous variable, each 1-unit increase in the global PSQI score resulted in an 18% increase in odds for suicidal ideation, even after adjusting for depression (aOR=1.18; 95% CI 1.08-1.28). Women with both poor subjective sleep quality and depression had a 3.5-fold increased odds of suicidal ideation (aOR=3.48; 95% CI 1.96-6.18) as compared with those who had neither risk factor.

CONCLUSION:

Poor subjective sleep quality was associated with increased odds of suicidal ideation. Replication of these findings may promote investments in studies designed to examine the efficacy of sleep-focused interventions to treat pregnant women with sleep disorders and suicidal ideation.

KEYWORDS:

Depression; Pregnancy; Sleep quality; Suicide; Suicide ideation

[Indexed for MEDLINE]
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