Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience

Objective: To examine the relationship between prenatal maternal stress, resilience, and sleep quality, and to determine whether resilience plays a mediating role in the relationship between prenatal maternal stress and sleep quality among pregnant women. Methods: Two hundred and thirty-one pregnant women in their second trimester participated in the study. They completed questionnaires, including: the Pittsburgh Sleep Quality Index (PSQI), the Pregnancy Stress Rating Scale (PSRS), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). A structural equation model was used to analyze the relationships among prenatal maternal stress, resilience, and sleep quality, with resilience as a mediator. Results: Prenatal maternal stress was negatively associated with sleep quality in pregnant women (p < 0.01), whereas resilience was positively associated with sleep quality (p < 0.01). Furthermore, resilience mediated the relationship between prenatal maternal stress and sleep quality, and the mediation effect ratio was 22.0% (p < 0.01). Conclusions: The risk factor for disturbed sleep was pregnancy-specific stress; however, the protective factor for sleep quality was resilience. This finding could provide scientific evidence for the development of intervention strategies with which to improve sleep quality in pregnant women. (C) 2016 Elsevier B.V. All rights reserved.