The Mediating Effect of Sleep Quality on the Relationship Between Depression and Sense of Control in Women in the Third Trimester of Pregnancy: A Cross-Sectional Survey Study.

Abstract

Background: Depression, poor sleep quality, and perceived lack of control all commonly impact women in the third trimester of pregnancy. Depression can influence sleep quality, whereas sense of control during pregnancy is correlated with both sleep quality and depression. However, the mediating effect of sleep quality on the relationship between depression and sense of control has not been examined in women in their third trimester.

Purpose: This study was designed to explore depression, sleep quality, and sense of control in pregnant women during the third trimester and determine the degree to which sleep quality mediates the relationship between depression and sense of control.

Methods: An exploratory correlational cross-sectional design was used to recruit 263 pregnant women with a gestational age of 35-36 weeks. Data were collected using questionnaires. Depression, sleep quality, and sense of control were respectively assessed using the Edinburgh Postnatal Depression Scale, Pittsburgh Sleep Quality Index, and Labor Agentry Scale. Data on the main outcomes were analyzed using the PROCESS macro for SPSS.

Results: Depression in pregnant women was found to correlate positively with poor sleep quality and negatively with sense of control (all p s < .001). Thus, higher levels of depression and poorer sleep quality were associated with lower sense of control. The results confirmed the relationship between depression and sense of control to be mediated by sleep quality ( p < .001).

Conclusions: Pregnant women with lower levels of depression may experience better sleep quality and sense of control. Sleep quality mediates the relationship between depression and sense of control in women in the third trimester. Thus, prenatal counseling and psychological support should be provided to pregnant women to reduce depression while improving sleep quality and sense of control.