title: Sleep quality and stress in women with pregnancy-induced hypertension and gestational diabetes mellitus.
abstract: BACKGROUND
  Pregnant women with complications including pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM) often experience disrupted sleep patterns because of activation of the sympathetic nervous system. These pathologies are aggravated by sympathetic nervous system activation and may be related to stress. The present study aimed to clarify the characteristics of and changes in sleep quality and stress in pregnant women with PIH and GDM during the second and third trimesters.
  
  
  METHODS
  We enrolled 56 women in their second or third trimesters who were diagnosed with PIH or GDM. Participants completed questionnaires, including the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS). Secretory immunoglobulin A (SlgA) concentrations were measured as a biological indicator of stress.
  
  
  RESULTS
  PSS scores and subjective stress parameters were significantly higher than those reported from previous studies of healthy pregnant women (15.2 points and 15.1 points for the second and third trimesters, respectively). Mean one-day values for SIgA were 168.3 and 205.7 μg/mL for the second and third trimesters, respectively. During the second and third trimesters, SIgA scores were higher than those reported for healthy pregnant women in previous studies. The PSQI component scores sleep disturbance (C5) and sleep duration (C3) in follow up case were significantly higher in the third trimester than in the second trimester.
  
  
  CONCLUSIONS
  This investigation suggests that pregnant women with PIH and GDM experience higher stress levels than do non-pregnant women and healthy pregnant women. Further, our results indicate that sleep quality worsens during the third trimester compared with the second trimester.
authors.affiliation: Osaka University, Graduate School of Medicine, Division of Health Sciences, 1-7 Yamadaoka, Suita, Osaka, Japan.
authors.forename: Mako
authors.initials: M
authors.lastname: Hayase
authors.affiliation: Osaka University, Graduate School of Medicine, Division of Health Sciences, 1-7 Yamadaoka, Suita, Osaka, Japan. Electronic address: shimadam@sahs.med.osaka-u.ac.jp.
authors.forename: Mieko
authors.initials: M
authors.lastname: Shimada
authors.affiliation: Saitama Medical University, Saitama Medical Center, Center for Maternal, Fetal and Neonatal Medicine, 1981 Kamoda, Kawagoe, Saitama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Seki
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis* / Q000209:etiology; D007071:Immunoglobulin A, Secretory / Q000097:blood*; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D020178:Sleep Disorders, Circadian Rhythm / Q000150:complications* / Q000503:physiopathology; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000503:physiopathology; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires
chemical_list: D007071:Immunoglobulin A, Secretory
keywords: Gestational diabetes mellitus; Pregnancy-induced hypertension; Secretory IgA; Sleep quality; Stress