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<p>Late pregnancy involves significant physiological and psychological challenges. However, the interplay between pregnancy-specific stress, sleep, and emotional problems remains underexplored, with key challenges including the unclear core stressors, undifferentiated specific mediating effects of distinct sleep dimensions, and lack of quantitative verification of causal pathways. This study addressed these gaps via integrated network analysis and PLS-SEM, identifying core stressors and specific sleep-mediated pathways, and quantifying their causal effects for the first time in Chinese late-pregnancy women.&#xa0;A cross-sectional study recruited 652 Chinese women in late pregnancy (≥ 28 weeks) from three hospitals. Measurement included Pregnancy Specific Stress Scale (PSS), Pittsburgh sleep quality index (PSQI), Epworth Sleepiness Scale (ESS), Generalized Anxiety Disorder scale (GAD-2), and Patient Health Questionnaire-2 (PHQ-2). Network analysis identified core variables, while PLS-SEM quantified direct and mediating effects.&#xa0;Network analysis revealed that concerns about “difficult birth,” “birth complications,” and “fetal safety” were central stressors, with the anxiety symptom “feeling nervous” emerging as a key mediating factor. PLS-SEM confirmed that pregnancy-specific stress directly predicted both anxiety and depression. Furthermore, subjective sleep quality partially mediated the relationship between stress and anxiety, while insomnia mediated the link between stress and depression. Excessive daytime sleepiness is prevalent and mediates stress-anxiety/depression links.&#xa0;Pregnancy-specific stress, sleep disturbances, and emotional problems form a complex interplay in late pregnancy. Sleep-related factor play a critical mediating role, highlighting targets for perinatal mental health interventions. This study clarifies the complex interaction mechanism between the three variables, fills the gap of unquantified sleep-mediated pathways in perinatal research, and provides evidence-based, targeted targets for clinical perinatal mental health interventions.</p>

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The correlation mechanism between pregnancy specific stress, sleep, and emotional problems in late pregnancy women

  • 期刊论文

  • 发表日期：

    2026年7月16日

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  • Min Li,
  • Yonghong Yang,
  • Chunyu Yang,
  • Yonghong Tang,
  • FengYing Zhang,
  • ShanYan Liu

摘要

Late pregnancy involves significant physiological and psychological challenges. However, the interplay between pregnancy-specific stress, sleep, and emotional problems remains underexplored, with key challenges including the unclear core stressors, undifferentiated specific mediating effects of distinct sleep dimensions, and lack of quantitative verification of causal pathways. This study addressed these gaps via integrated network analysis and PLS-SEM, identifying core stressors and specific sleep-mediated pathways, and quantifying their causal effects for the first time in Chinese late-pregnancy women. A cross-sectional study recruited 652 Chinese women in late pregnancy (≥ 28 weeks) from three hospitals. Measurement included Pregnancy Specific Stress Scale (PSS), Pittsburgh sleep quality index (PSQI), Epworth Sleepiness Scale (ESS), Generalized Anxiety Disorder scale (GAD-2), and Patient Health Questionnaire-2 (PHQ-2). Network analysis identified core variables, while PLS-SEM quantified direct and mediating effects. Network analysis revealed that concerns about “difficult birth,” “birth complications,” and “fetal safety” were central stressors, with the anxiety symptom “feeling nervous” emerging as a key mediating factor. PLS-SEM confirmed that pregnancy-specific stress directly predicted both anxiety and depression. Furthermore, subjective sleep quality partially mediated the relationship between stress and anxiety, while insomnia mediated the link between stress and depression. Excessive daytime sleepiness is prevalent and mediates stress-anxiety/depression links. Pregnancy-specific stress, sleep disturbances, and emotional problems form a complex interplay in late pregnancy. Sleep-related factor play a critical mediating role, highlighting targets for perinatal mental health interventions. This study clarifies the complex interaction mechanism between the three variables, fills the gap of unquantified sleep-mediated pathways in perinatal research, and provides evidence-based, targeted targets for clinical perinatal mental health interventions.