THE IMPACT OF A POST-DELIVERY SLEEP PROTECTION INTERVENTION ON POSTPARTUM MATERNAL MENTAL HEALTH

Abstract

INTRODUCTION: Poor sleep quality is a significant risk factor for the development of postpartum depression. This thesis examined the impact of a post-delivery intervention which promoted and protected sleep during the immediate postpartum period on maternal mood, sleep quality, and anxiety. METHODS: 41 women with lifetime or current mood and/or anxiety disorders (12 receiving the intervention) were enrolled in this prospective naturalistic cohort study from the third trimester of pregnancy until 24 weeks postpartum. Depression, the primary outcome, was measured using the Edinburgh Postnatal Depression Scale at 12 weeks postpartum. Remaining outcomes (sleep quality and anxiety) were measured using self-report questionnaires (Insomnia Severity Index and State-Trait Anxiety Inventory, respectfully), and objective measures (i.e., actigraphy for sleep quality). RESULTS: There were no significant differences between the comparison and intervention group in depressive symptomatology at postpartum week 12 (primary outcome). On our secondary outcomes, we found that there were no significant differences in subjective and objective sleep quality at postpartum week two, or anxiety symptomatology at postpartum week eight between the two groups. There were also no significant differences in breastfeeding rates between the two groups at postpartum week 24. CONCLUSION AND FUTURE DIRECTIONS: Floor effects, specialized perinatal psychiatric treatment for a specific population, and low statistical power offer explanations for the observed null results. Strengths of our study include diagnosis of mood/anxiety disorders using the gold-standard (i.e., clinician diagnosis), and use of objective sleep measures. Future studies may benefit from implementing this intervention in resource-poor settings, using adequately powered research designs.