Nature and Science of Sleep (Mar 2024)
The Mediating Role of Family Functions Between Pregnancy-Related Anxiety and Sleep Quality: A Cross-Sectional Study
Abstract
Jiashu Zhu,1 Ye Li,1 Rui Wang,1 Jinfang Zhang,2 Can Liu,1 Hongyu Li,1 Deguang Yang,1 Shuqin Ma,2 Suzhen Guan1 1School of Public Health, Ningxia Medical University, Yinchuan City, Ningxia, People’s Republic of China; 2Obstetric Clinic, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia, People’s Republic of ChinaCorrespondence: Suzhen Guan, School of Public Health, Ningxia Medical University, Yinchuan City, Ningxia, 750004, People’s Republic of China, Tel +86 13389511821, Email [email protected] Shuqin Ma, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia, 750004, People’s Republic of China, Tel +86 13895493649, Email [email protected]: To examine the relationship between pregnancy-related anxiety, family functions, and sleep quality, and to determine whether family functions mediate the relationship between pregnancy-related anxiety and sleep quality.Methods: A cross-sectional survey was conducted on pregnant women between April to August in 2022 in the obstetrics outpatient clinic of a tertiary care hospital in the Ningxia Hui Autonomous Region of China. A total of 1014 pregnant women aged 18 years and older were surveyed. They completed questionnaires, including: general demographic characteristics, the Pregnancy-related anxiety scale (PAQ), the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR), and the Pittsburgh Sleep Quality Index Questionnaire (PSQI). Model 4 in PROCESS was used to analyze the relationships among pregnancy-related anxiety, family functions, and sleep quality, with family functions as a mediator.Results: Among the 1014 pregnant women, the pregnancy-related anxiety scale score was (21.84 ± 5.64). The total score of the family functions scale was (8.10± 2.26), and the overall sleep quality scale score was (7.89± 2.99). When participants were grouped according to different socio-demographic characteristics, the study showed that all variables differed from anxiety, family functions or sleep quality, except for age, pre-pregnancy BMI and whether or not they had a first birth, which was not associated with anxiety, family functions, or sleep quality (P< 0.05). The pregnancy-related anxiety was positively associated with sleep quality (P< 0.01), while family functions were negatively associated with sleep quality (P< 0.01). In addition, family functions mediate the relationship between pregnancy-related anxiety and sleep quality during pregnancy, on the first and second trimesters, intermediation rate is 9.31% (P< 0.05), and on the third trimesters, intermediation rate is 21.38% (P< 0.05).Conclusion: Pregnancy- related anxiety is a risk factor for sleep quality, however, family functions are protective factors for sleep quality. Family functions play an intermediary role in sleep quality caused by pregnancy-related anxiety, especially on the third trimesters. This finding may provide a scientific basis for developing intervention strategies to improve the sleep quality of pregnant women.Keywords: pregnancy-related anxiety, family functions, sleep quality, mediation effect
