Prenatal insomnia and childbirth-related PTSD symptoms: A prospective population-based cohort study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Camille Deforges - , University of Lausanne (Author)
  • Yvonnick Noël - , Université de Rennes 1 (Author)
  • Malin Eberhard-Gran - , University of Oslo (Author)
  • Susan Garthus-Niegel - , Institute and Policlinic of Occupational and Social Medicine, MSH Medical School Hamburg, Norwegian Institute of Public Health (Author)
  • Antje Horsch - , University of Lausanne (Author)

Abstract

Background: Certain populations are at high risk of experiencing a traumatic event and developing post-traumatic stress disorder (PTSD). Yet, primary preventive interventions against PTSD are lacking. It is therefore crucial to identify pre-traumatic risk factors, which could be targeted with such interventions. Insomnia may be a good candidate, but studies on civilians are sparse. Furthermore, the mechanisms at stake in the relationship between pre-traumatic insomnia and PTSD symptoms are unclear. Methods: This prospective population-based cohort study (n = 1,610) examined the relationship between insomnia symptoms at 32 weeks of pregnancy and childbirth-related PTSD (CB-PTSD) symptoms at eight weeks postpartum. Postnatal insomnia symptoms, prenatal psychological symptoms (depression, anxiety, PTSD, fear of childbirth), subjective birth experience (SBE) and birth medical severity were included as covariates in the analyses, which were based on a Piecewise Structural Equation Modelling approach. Results: The relationship between prenatal insomnia and CB-PTSD symptoms was mediated by negative SBE and postnatal insomnia symptoms. All relationships involving insomnia symptoms had small or very small effect sizes. Limitations: This study used self-report questionnaires. Postnatal insomnia and CB-PTSD symptoms were concurrently measured. Conclusion: Prenatal insomnia symptoms may impair the ability to cope with a difficult birth experience and contribute to postnatal insomnia, a risk factor for CB-PTSD. Thus, prenatal insomnia symptoms may be a promising target for CB-PTSD primary preventive interventions, although other prenatal psychological symptoms could also be considered. Even beyond the perinatal context, future studies on pre-traumatic insomnia and PTSD should include post-traumatic insomnia as a covariate.

Details

Original languageEnglish
Pages (from-to)305-315
Number of pages11
JournalJournal of Affective Disorders
Volume295
Publication statusPublished - 1 Dec 2021
Peer-reviewedYes

External IDs

PubMed 34488084
ORCID /0000-0002-7472-674X/work/142257752

Keywords

Sustainable Development Goals

Keywords

  • Childbirth, Insomnia, Posttraumatic stress disorder, Pregnancy, Prevention, Risk factors

Library keywords