In this study, we present the impact of second hand smoking as a mediating factor.
This prospective study included 196 pregnant women interviewed during pregnancy and after pregnancy. Depressive symptoms were assessed during and after pregnancy using EPDS questionnaire while exposure to tobacco smoking (ETS) and sleep quality (PSQI) were assessed during pregnancy using questionnaires. Since the data is hierarchical in nature, we used an Upper level mediation model, in which the effect of a Level 2 predictor (PSQI) on a Level 1 outcome (EPDS) is mediated by another Level 2 predictor (ETS). A random effect structural equation model was applied to the data and was formulated in two parts (a structural and a measurement part). The indices obtained indicated adequate model fit.
Our findings suggest that disrupted sleep may induce perinatal depressive symptoms which might result in decrease birth rate, and may affect mental health during pregnancy.
These findings highlight the need to develop interventions that will minimize factors such as ETS in pregnant women who suffer from low sleep quality, an important step in mitigating the risk of depression among vulnerable population
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