title: Sleep Moderates and Mediates the Relationship Between Acculturation and Depressive Symptoms in Pregnant Mexican-American Women.
abstract: OBJECTIVE
  Greater acculturation is associated with adverse perinatal outcomes in Mexican-American women, but the mechanisms by which acculturation influences perinatal outcomes are unclear. Pregnant acculturated Mexican-American women are more likely to engage in unhealthy prenatal behaviors relative to those less acculturated, including poor sleep. As sleep disruptions are associated with acculturation and negative perinatal outcomes, particularly maternal depression, alterations in sleep may adversely affect pregnant Mexican-American women.
  
  
  METHODS
  Sixty pregnant women of Mexican descent completed surveys about sleep, acculturation, depressive symptoms and potential protective factor of social support.
  
  
  RESULTS
  Acculturation, but not social support, significantly predicted increased sleep disruptions as well as overall feeling less refreshed upon waking across pregnancy. Moderation analysis indicated that more acculturated women who took longer to fall asleep reported increased depressive symptoms. Feeling refreshed upon waking also mediated the relationship between increased acculturation and elevated maternal depressive symptoms.
  
  
  CONCLUSIONS
  Acculturation and altered sleep contribute to greater risk in Mexican-American women for maternal depressive symptoms in the perinatal period. These findings have implications for prevention and treatment of maternal mental health disorders, which may adversely affect perinatal outcomes in the vulnerable Mexican-American population.
authors.affiliation: Department of Psychology, SBSB 3229, California State University San Marcos, 333 S. Twin Oaks Valley Rd, San Marcos, CA, 92096, USA. kdanna@csusm.edu.
authors.forename: Kimberly L
authors.initials: KL
authors.lastname: D'Anna-Hernandez
authors.affiliation: Department of Psychology, SBSB 3229, California State University San Marcos, 333 S. Twin Oaks Valley Rd, San Marcos, CA, 92096, USA.
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Garcia
authors.affiliation: Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Coussons-Read
authors.affiliation: Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Laudenslager
authors.affiliation: Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Randal G
authors.initials: RG
authors.lastname: Ross
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D005190:Family; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D017058:Mexican Americans / Q000523:psychology* / Q000706:statistics & numerical data; D008800:Mexico / Q000208:ethnology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D037841:Pregnant People / Q000208:ethnology* / Q000523:psychology; D012307:Risk Factors; D012890:Sleep; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Immigrant; Mood; Mother; Perinatal; Pregnancy