Sleep Moderates and Mediates the Relationship Between Acculturation and Depressive Symptoms in Pregnant Mexican-American Women

• Published in: Maternal and child health journal 2016-02, Vol.20 (2), p.422-433
• Main Authors: D’Anna-Hernandez, Kimberly L., Garcia, Esmeralda, Coussons-Read, Mary, Laudenslager, Mark L., Ross, Randal G.
• Format: Article
• Language: English
• Subjects: Acculturation; Adolescent; Adult; Cross-Sectional Studies; Depression - diagnosis; Depression - ethnology; Depression - psychology; Family; Female; Gynecology; Health aspects; Hispanic Americans; Humans; Longitudinal Studies; Low income groups; Maternal and Child Health; Medicine; Medicine & Public Health; Mexican American women; Mexican Americans - psychology; Mexican Americans - statistics & numerical data; Mexico - ethnology; Mothers; Patient outcomes; Pediatrics; Population Economics; Pregnancy; Pregnancy Complications - epidemiology; Pregnancy Complications - psychology; Pregnant women; Pregnant Women - ethnology; Pregnant Women - psychology; Public Health; Risk Factors; Sleep; Social Support; Socioeconomic Factors; Sociology; United States - epidemiology; Womens health; Young Adult
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-015-1840-9

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.