Childhood adversity and sleep are associated with symptom severity in perinatal women presenting for psychiatric care

Arch Womens Ment Health. 2019 Aug;22(4):457-465. doi: 10.1007/s00737-018-0914-2. Epub 2018 Oct 1.


This study leverages psychiatric intake data from treatment-seeking perinatal women aiming to explore the understudied associations between childhood adversity, sleep quality, and severity of perinatal mental illness in this population. The sample is 578 perinatal women presenting for initial evaluation to a university-based perinatal psychiatry clinic. At intake, we collected demographics, adverse childhood experiences (ACEs), sleep quality, and diagnosis and symptom severity of depression, anxiety, and posttraumatic stress disorder (PTSD). Clinician-rated diagnoses showed that 65% of women met criteria for major depression, 23% for generalized anxiety disorder and 4% for PTSD; almost 30% of women had childhood adversity and 98.2% reported poor perinatal sleep quality. Regression analyses revealed differential associations between ACEs and sleep quality and perinatal mood symptoms; ACEs were significantly associated with pregnancy and postpartum PTSD, whereas sleep quality was associated with perinatal depression and generalized anxiety. Screening for ACEs and sleep quality during perinatal intake has high clinical utility, as these two factors significantly contribute to symptom severity across peripartum.

Keywords: ACEs; Perinatal psychiatric care; Perinatal psychopathology; Sleep quality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Adverse Childhood Experiences*
  • Anxiety / complications
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Child
  • Child Abuse, Sexual / psychology
  • Depression / complications
  • Depression / epidemiology*
  • Depression / psychology
  • Female
  • Humans
  • Perinatal Care
  • Postpartum Period
  • Pregnancy
  • Pregnant Women / psychology*
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Young Adult