The Development of a New Understanding of Symptom Cluster During Pregnancy Using the Mediation Model

Fatigue, depression and sleep disturbance are regarded as a symptom cluster associated with pregnancy. The mediation effect of sleep disturbance on the relationship between depression on fatigue is still unclear.

To assess the mediation effect of sleep disturbance on the established relationship between depression and fatigue among pregnant women.

This study used a cross-sectional design. Pregnant women (n = 130) at a private gynecology and obstetrics outpatient clinic in Amman, Jordan. Participants were recruited to complete the Brief Fatigue Inventory, the Insomnia Severity Index, and the Zung depression scale, in addition to the demographic questionnaire. The mediation effect was examined through a Hierarchal Multiple Regression model.

A total of 130 pregnant women participated (mean of ages= 27.3). Of those, 41.5% were in the first trimester, while the rest were in their second and the third trimesters (27.7%, and 30.8%, respectively). Regression analysis indicated that about 23% of the variation of fatigue was explained by depression. Nonetheless, 47% of the variance of fatigue was explained by depression after identifying the mediation effect of sleep disturbance.

The mediation role of sleep disturbance between depression and fatigue added a new approach to the assessment and prognosis of fatigue during pregnancy.