title: The relationship between sleep disturbance in pregnancy and persistent common mental disorder in the perinatal period (sleep disturbance and persistent CMD).
abstract: BACKGROUND
  Common mental disorder (CMD) and sleep disturbance are two common conditions among women in late pregnancy, affecting up to 20% and 63% of women, respectively, and may adversely affect their quality of life.
  
  
  OBJECTIVE
  The aim of this study is to examine the relationship between sleep disturbance in pregnancy and persistent CMD among low-income pregnant women living in Brazil.
  
  
  METHODS
  This was a prospective cohort study conducted with pregnant women recruited from public primary care clinics in São Paulo, Brazil. We performed a longitudinal analysis of 219 women who had CMD from the Self-Report Questionnaire during the 20-30 weeks of pregnancy. Two groups were examined: (1) those who had CMD remission in the postpartum and (2) those who had persistent CMD in the postpartum (measured once in the postpartum period). Poisson regression was used to estimate the degree of association between sleep disturbance in pregnancy and the risk for persistent CMD postpartum.
  
  
  RESULTS
  After adjusting for sociodemographic and clinical factors, sleep disturbance during pregnancy is associated with persistent CMD (RR = 1.36, 95% confidence interval: 1.01-1.84).
  
  
  CONCLUSIONS
  In this sample of low-income pregnant women living in Brazil, the presence of sleep disturbance during pregnancy was associated with persistent common mental disorder in the postpartum period. Identification of sleep disturbance in pregnant women with CMD will be important in order to recognize those women at higher risk of persistent CMD in the postpartum period.
authors.affiliation: a Cambridge Health Alliance, Harvard Medical School , Cambridge , MA , USA .
authors.forename: Joanna Vaz
authors.initials: JV
authors.lastname: MacLean
authors.affiliation: b University of São Paulo , São Paulo , Brazil .
authors.forename: Alexandre
authors.initials: A
authors.lastname: Faisal-Cury
authors.affiliation: c University of Washington Medical School , Seattle , WA , USA.
authors.forename: Ya-Fen
authors.initials: YF
authors.lastname: Chan
authors.affiliation: b University of São Paulo , São Paulo , Brazil .
authors.forename: Paulo Rossi
authors.initials: PR
authors.lastname: Menezes
authors.affiliation: a Cambridge Health Alliance, Harvard Medical School , Cambridge , MA , USA .
authors.forename: Amanda
authors.initials: A
authors.lastname: Winters
authors.affiliation: a Cambridge Health Alliance, Harvard Medical School , Cambridge , MA , USA .
authors.forename: Robert
authors.initials: R
authors.lastname: Joseph
authors.affiliation: a Cambridge Health Alliance, Harvard Medical School , Cambridge , MA , USA .
authors.forename: Hsiang
authors.initials: H
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011446:Prospective Studies; D057566:Self Report; D012893:Sleep Wake Disorders / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult
keywords: common mental disorder; depression; pregnancy; sleep disturbance; women’s mental health