Sleep Quality and Depressive Symptoms Among Pregnant Women in the Third Trimester: A Cross-Sectional Latent Profile and Network Analysis.

PURPOSE: To identify heterogeneous sleep-quality profiles among pregnant women in the third trimester and characterize profile-specific sleep quality-depressive symptom network structures. PATIENTS AND METHODS: This cross-sectional study included 471 pregnant women in the third trimester attending antenatal care at a tertiary Grade A hospital in China. Sleep quality and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Self-Rating Depression Scale (SDS), respectively. Latent profile analysis was used to identify sleep-quality subgroups, followed by network analysis in subgroups with adequate sample sizes. RESULTS: Four sleep-quality profiles were identified: the moderate multidimensional sleep impairment group (n=177, 37.6%), daytime dysfunction group (n=85, 18.1%), good sleep quality group (n=182, 38.6%), and low sleep efficiency group (n=27, 5.7%). Because of its small sample size, the low sleep efficiency group was excluded from formal network analysis. SDS11 ("emptiness in life") had the highest strength in the moderate multidimensional sleep impairment and good sleep quality groups, whereas SDS1 ("depressed mood") had the highest strength in the daytime dysfunction group. PSQI6 ("daytime dysfunction") had the highest bridge strength in all three analyzed networks. After Holm correction, the moderate multidimensional sleep impairment group showed significantly higher global strength than the good sleep quality group (6.531 vs 4.839; adjusted P=0.012). CONCLUSION: Sleep quality showed substantial heterogeneity among pregnant women in the third trimester, and sleep quality-depressive symptom network characteristics differed across sleep-quality profiles. These findings provide exploratory evidence on subgroup-specific symptom associations and warrant further validation in prospective studies.