Sleep Quality, Associated Factors, and Pregnancy Outcomes in Women Delivered at Kenyatta National Hospital: (a Cross-sectional Study With Subgroup Analysis)

Abstract

Background: Sleep quality and quantity changes are common in pregnancy and may expose mothers to both physical-mental illnesses and impact negatively on the pregnancy. However, during preconception and antenatal care, mental health isn’t routinely addressed. Mothers enjoy the privileges of physical evaluation, investigation, and supplement medications but no mental care. It is good to appreciate that poor sleep quality and quantity may facilitate the development of mental illnesses during pregnancy like depression and anxiety or result secondarily from them. Sleep changes can also be a manifestation of physical illness in pregnancy or micronutrients deficiencies; folate, iron, and calcium. Pain during pregnancy, infections and endocrine diseases amongst other medical conditions may interfere with sleep and hence treatment of these conditions will help resolve the sleep disturbances and impact positively on the pregnancy. Pregnancy-associated medical conditions like preeclampsia, diabetes and fetal intrauterine growth restrictions have been associated with poor sleep disturbances. This demonstrates the need to be aware of sleep disturbances in pregnancy and manage them where necessary during pregnancy. Local data on the degree of the problem in pregnant women is lacking. Purpose of the study. To determine the prevalence of poor sleep quality, associated factors and associated pregnancy outcomes in pregnant women delivered at KNH between July 2022 and June 2023. Methodology and analysis. Study design: This was a cross-sectional study with subgroup analysis. Study setting: The study was conducted at Kenyatta National Hospital. Study population: The study targeted the pregnant women who delivered at KNH between 28 – 42 weeks gestation. Simple random sampling was used to pick participants. Participant’s data was collected between August and November 2022. Once sleep quality was determined, two arms of poor sleep quality and good sleep quality were used as subgroups, and analyzed for association with factors and outcomes collected. Sample size: 420 participants were recruited for all objectives at 90% power. Data collection and analysis: A questionnaire was administered capturing the socio-demographic, clinical, lifestyle and pregnancy outcomes. Data was transferred from questionnaire to excel format and coded. Coded data was then transferred to SPSS 23 for analysis...