title: The association between prenatal sleep quality and obstetric outcome.
abstract: BACKGROUND
  Pregnancy-associated sleep disorder is a new category on the latest version of the International Classification of Sleep Disorders. It is a significant problem for pregnant women.
  
  
  OBJECTIVE
  The present follow-up study assesses the association between sleep quality during the second and third trimesters of pregnancy and obstetric-neonatal outcomes.
  
  
  METHODS
  A prospective follow-up study design was used. Follow-up examination of the obstetric birth records in the immediate postpartum period were carried out on 128 second-trimester and 120 third-trimester women and their newborns in two hospitals in Taiwan. Poor sleep quality was identified using the Pittsburgh Sleep Quality Index. Data were collected from October 2007 to June 2008.
  
  
  RESULTS
  The prevalence of poor sleepers (Pittsburgh Sleep Quality Index score > 5) was 58% for second-trimester participants and 66% for third-trimester participants; participants who were unemployed reported a significantly higher prevalence of poor sleep quality than those who were employed. Subsequent review of the participant's obstetric birth records revealed that third-trimester poor sleepers were more likely to have had a vacuum-assisted delivery.
  
  
  CONCLUSIONS
  This study identified poor sleep quality during the third trimester as a novel risk factor for vacuum-assisted delivery. We suggest that prenatal healthcare providers focus greater attention to the sleep disturbance condition of pregnant women and provide proactive sleep counseling to facilitate pregnant women's adjustment to the new psychosocial and physiological demands of motherhood.
authors.affiliation: 1PhD, RN, Assistant Professor, Department of Nursing, Tajen University 2PhD, RN, Associate Professor, Department of Nursing, Hung Kuang University 3PhD, RN, Professor, Institute of Allied Health Sciences and Department of Nursing, National Cheng Kung University.
authors.forename: Hsuan-Man
authors.initials: HM
authors.lastname: Hung
authors.forename: Shu-Hua
authors.initials: SH
authors.lastname: Ko
authors.forename: Chung-Hey
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012890:Sleep