Korean J Women Health Nurs.  2014 Sep;20(3):195-203. 10.4069/kjwhn.2014.20.3.195.

Relationship between Fatigue, Sleep Disturbance, and Gestational Stress among Pregnant Women in the Late Stages

• Chung MY
• Hwang KH
• Cho OH

• KMID: 2307930
• DOI: http://doi.org/10.4069/kjwhn.2014.20.3.195

Abstract

PURPOSE
The objective of this study was to investigate the relationship between fatigue, sleep disturbance, and gestational stress in women during late stage of pregnancy.
METHODS
This study was conducted with 113 healthy pregnant women at gestational age greater than 27 weeks who were registered at community health centers and received prenatal care. A structured questionnaire regarding fatigue, sleep disturbance, and gestational stress was used. The data was analyzed using a t-test, an ANOVA, and Pearson correlation coefficients.
RESULTS
The subjects with unplanned pregnancies and irregular exercise patterns showed a higher level of fatigue than those with planned pregnancies and regular exercise patterns. Pregnant women with caffeine intake manifested higher levels of gestational stress and sleep disturbance than those without. The levels of sleep disturbance and gestational stress increased as the fatigue levels increased. The fatigue levels increased with increased levels of sleep disturbance.
CONCLUSION
Planned pregnancy, regular exercise patterns, and caffeine intake were related with fatigue, sleep disturbance, and gestational stress in women during late stages of pregnancy. Fatigue, sleep disturbance, and gestational stress had close associations to each other. In the future, such results should guide development of nursing intervention programs for women in late stages of pregnancy.

Keyword

Pregnant women; Fatigue; Sleep disorders; Stress

MeSH Terms

Caffeine
Community Health Centers
Family Planning Services
Fatigue*
Female
Gestational Age
Humans
Nursing
Pregnancy
Pregnancy, Unplanned
Pregnant Women*
Prenatal Care
Surveys and Questionnaires
Sleep Wake Disorders
Caffeine

Reference

1. Nazik E, Eryilmaz G. Incidence of pregnancy-related discomfort and management approaches to relieve them among pregnant women. J Clin Nurs. 2014; 23(11-12):1736–1750.

2. Hall WA, Hauck YL, Carty EM, Hutton EK, Fenwick J, Stoll K. Childbirth fear, anxiety, fatigue, and sleep deprivation in pregnant women. J Obstet Gynecol Neonatal Nurs. 2009; 38(5):567–576.

3. Balendran J, Champion D, Jaaniste T, Welsh A. A common sleep disorder in pregnancy: Restless legs syndrome and its predictors. Aust N Z J Obstet Gynaecol. 2011; 51(3):262–264.

4. Okun ML, Hanusa BH, Hall M, Wisner KL. Sleep complaints in late pregnancy and the recurrence of postpartum depression. Behav Sleep Med. 2009; 7(2):106–117.

5. Leung PL, Hui DS, Leung TN, Yuen PM, Lau TK. Sleep disturbances in Chinese pregnant women. BJOG. 2005; 112(11):1568–1571.

6. Kim YH, Cho OH. Factors influencing fatigue in pregnant women. J Korean Soc Matern Child Health. 2012; 16(1):80–88.

7. Ko H, Shin J, Kim MY, Kim YH, Lee J, Kil KC, et al. Sleep disturbances in Korean pregnant and postpartum women. J Psychosom Obstet Gynaecol. 2012; 33(2):85–90.

8. Lopes EA, Carvalho LB, Seguro PB, Mattar R, Silva AB, Prado LB, et al. Sleep disorders in pregnancy. Arq Neuropsiquiatr. 2004; 62(2A):217–221.

9. Kızılırmak A, Timur S, Kartal B. Insomnia in pregnancy and factors related to insomnia. ScientificWorldJournal. 2012; 2012:197093.

10. Kamysheva E, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. A prospective investigation of the relationships among sleep quality, physical symptoms, and depressive symptoms during pregnancy. J Affect Disord. 2010; 123(1-3):317–320.

11. Dørheim SK, Bjorvatn B, Eberhard-Gran M. Can insomnia in pregnancy predict postpartum depression? a longitudinal, population-based study. PLoS One. 2014; 9(4):e94674.

12. Ahn HR. Experimental study of the effects of husband's supportive behavior reinforcement education on stress relief of primigravidas [dissertation]. Seoul: Yonsei University;1984.

13. Chou FH, Kuo SH, Wang RH. A longitudinal study of nausea and vomiting, fatigue and perceived stress in, and social support for, pregnant women through the three trimesters. Kaohsiung J Med Sci. 2008; 24(6):306–314.

14. Parcells DA. Women's mental health nursing: Depression, anxiety and stress during pregnancy. J Psychiatr Ment Health Nurs. 2010; 17(9):813–820.

15. Jeong GH, Kim SJ. Differences of women's perception of fatigue according to the period of pregnancy. J Korean Acad Nurs. 2000; 30(3):731–740.

16. Hong SH, Kim KH. A study on the stress of pregnant and the coping of pregnant. Korean J Fam Welf. 2001; 6(2):115–128.

17. Kwon MK, Bang KS. Relationship of prenatal stress and depression to maternal-fetal attachment and fetal growth. J Korean Acad Nurs. 2011; 41(2):276–283.

18. Tack B. Dimensions and correlated of fatigue in older adults with rheumatoid arthritis [dissertation]. San Francisco: University of California;1991.

19. Lee KS. Prediction model of fatigue in women with rheumatoid arthritis [dissertation]. Seoul: Seoul National University;1999.

20. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193–213.

21. Kim GD. A study on quality of sleep and emotional health status in the elderly [master's thesis]. Daegu: Kyungpook National University;1998.

22. Kim JS, Lee YS. Study on fatigue, stress and burnout of pregnant nurses. Korean J Occup Health Nurs. 2013; 22(3):208–217.

23. Kim YA. Relationship between maternal stress during pregnancy and neonatal stress response [master's thesis]. Seoul: Seoul National University;2007.

24. Gaston A, Prapavessis H. Tired, moody and pregnant? exercise may be the answer. Psychol Health. 2013; 28(12):1353–1369.

25. Hung HM, Tsai PS, Ko SH, Chen CH. Patterns and predictors of sleep quality in Taiwaneses pregnant women. MCN Am J Matern Child Nurs. 2013; 38(2):95–101.

26. Ko SH, Chang SC, Chen CH. A comparative study of sleep quality between pregnant and nonpregnant Taiwanese women. J Nurs Scholarsh. 2010; 42(1):23–30.

27. Lee KA, Zaffke ME, McEnany G. Parity and sleep patterns during and after pregnancy. Obstet Gynecol. 2000; 95(1):14–18.

28. Tsubouchi H, Shimoya K, Hayashi S, Toda M, Morimoto K, Murata Y. Effect of coffee intake on blood flow and maternal stress during the third trimester of pregnancy. Int J Gynaecol Obstet. 2006; 92(1):19–22.

29. Diego M, Field T, Hernandez-Reif M, Vera Y, Gil K, Gonzalez-Garcia A. Caffeine use affects pregnancy outcome. J Child Adolesc Subst Abuse. 2007; 17(2):41–49.

30. Fairbrother N, Hutton EK, Stoll K, Hall W, Kluka S. Psychometric evaluation of the multidimensional assessment of fatigue scale for use with pregnant and postpartum women. Psychol Assess. 2008; 20(2):150–158.