ArticleJA clinical reports2025
Self-reported poor sleep quality on the day of delivery is a potential risk factor for postpartum depression after cesarean delivery: a retrospective cohort study.
Article in JA clinical reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPostpartum depression (PPD) affects a significant number of women. Sleep disturbances have been associated with PPD; however, it remains unclear whether immediate postpartum sleep disturbances are risk factors. We investigated the potential association between self-reported poor sleep quality on the first day after cesarean delivery and the development of PPD, measured using the Edinburgh Postnatal Depression Scale (EPDS) scores.
methodsWe conducted a retrospective cohort study of women who underwent elective cesarean delivery under neuraxial anesthesia. Patients were asked about their sleep quality on the day after surgery and divided into Poor and Good Sleep groups. The EPDS scores were recorded at one month postpartum. The postpartum EPDS scores were compared between the two groups, and potential confounding factors were adjusted for using propensity score matching.
resultsA total of 256 patients (55 and 201 in the Poor and Good Sleep groups, respectively) were included in the analysis. After propensity score matching, the postnatal EPDS score was significantly higher in the Poor Sleep group compared to that in the Good Sleep group (6.7 ± 5.2 vs 4.5 ± 4.3, P = 0.007). Maternal PPD (i.e., EPDS ≥ 9) was also significantly higher in the Poor Sleep group (31.5% vs 17.5%, P = 0.045, OR 2.17 [95%CI 1.01–4.67]). The Poor Sleep group had higher endocrine morbidity and a higher rate of multiple gestations.
conclusionThere is a strong correlation between self-reported poor sleep quality on the first day after cesarean delivery and the EPDS score one month after childbirth. Sleep disturbances on the day of delivery may be a potential risk factor for PPD.
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