Perinatal stressors and sleep quality in adolescents: a Brazilian birth cohort study

Resumo

Objective
To investigate whether perinatal stressors (gestational weight gain, maternal age, marital status, and maternal body composition) exert a direct effect on sleep quality in adolescence; whether these effects are mediated by socioeconomic factors, lifestyle, and comorbidities; and whether depression, screen time, and physical activity have a direct effect on adolescents’ sleep quality.
Methods
Longitudinal cohort study was nested within a Brazilian birth cohort including 527 participants aged 18–19 years. Structural equation modeling was used to examine pathways linking perinatal stressors to sleep quality. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Explanatory variables included perinatal maternal characteristics, socioeconomic factors, lifestyle, and adolescent comorbidities.
Results
Among perinatal stressors, only maternal marital status at birth showed a direct effect on adolescents’ sleep quality (coef = 0.14; p = 0.027). Depression (coef = 0.38; p = 0.001) and asthma (coef = 0.19; p = 0.030) were directly associated with poorer sleep quality. No evidence of mediation by socioeconomic status, lifestyle, or comorbidities was found. Other perinatal stressors, screen time, and physical activity were not associated with sleep quality.
Conclusions
Maternal marital instability during the perinatal period may have lasting consequences for adolescents’ sleep quality, possibly through direct neurobiological mechanisms. Depression and asthma emerged as predictors of poor sleep quality, underscoring the need for integrated early screening and intervention strategies.