ArticleBMC pregnancy and childbirth2026
Association of psychological states, sleep patterns, vaccine, and pregnancy outcomes during the COVID-19 pandemic.
Article in BMC pregnancy and childbirth, 2026. 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
objectiveThis study investigates the relationships among psychological state, sleep patterns, COVID-19 vaccination during the COVID-19 pandemic, with postpartum hemorrhage as the primary outcome, and other adverse pregnancy outcomes, mental health, and sleep quality as secondary outcomes.
methodsA prospective cohort study was conducted from April 2022 to November 2022 at the First Affiliated Hospital of Sun Yat-sen University, including 260 pregnant women meeting the inclusion criteria in the obstetric department. The Depression Anxiety Stress Scales (DASS-21) was used to assess depression, anxiety, and stress; the Impact of Event Scale-Revised (IES-R) was utilized to evaluate psychological stress related to COVID-19, and the Pittsburgh Sleep Quality Index (PSQI) was employed to measure sleep quality; Participants were grouped based on their scores or vaccination status (vaccinated: n = 204; unvaccinated: n = 56), and the incidence of adverse pregnancy outcomes was compared among different groups.
resultsThe primary outcome showed that the incidence of postpartum hemorrhage (PPH) differed significantly across depression subgroups (normal: 3.6%, mild: 15.0%, moderate-severe: 13.0%; χ²(2) = 9.450). Compared with the non-depression group, mild depression was significantly associated with an increased risk of PPH (OR = 4.19, 95% CI: 1.15-15.18, P = 0.006); moderate-to-severe depression was also significantly associated with an elevated risk of PPH (OR = 4.78, 95% CI: 1.39-16.40, P = 0.013). For secondary outcomes, no significant differences in adverse pregnancy outcomes were observed among groups stratified by anxiety, stress, COVID-19-related psychological stress, or sleep quality (all P > 0.05).In addition, pre-pregnancy inactivated COVID-19 vaccination was not associated with an elevated risk of PPH or other adverse pregnancy outcomes(P > 0.05).
conclusionCOVID-19-related depressive symptoms are associated with an increased risk of postpartum hemorrhage. Pre-pregnancy COVID-19 vaccination showed no adverse effects on maternal mental health or pregnancy outcomes.
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