ปัจจัยทำนายการนอนไม่หลับในสตรีตั้งครรภ์ที่มีภาวะอ้วน

Abstract

Insomnia among pregnant women with obesity affects them and their infants during the antepartum, intrapartum, and postpartum periods. The purpose of this predictive correlational study was to investigate insomnia and the factors predicting insomnia among pregnant women with obesity, including pre-pregnancy body mass index, pregnancy-related anxiety, and dysfunctional beliefs and attitudes about sleep. The participants were pregnant women with obesity who were 28 weeks of gestational age or older, and attended the antenatal clinic of Maharaj Nakorn Chiang Mai Hospital, Health Promotion Center Region 1 Chiang Mai, Lamphun Hospital, and Uttaradit Hospital between June and August 2023. The 115 participants were selected based on the inclusion criteria. The study instruments consisted of the Personal Information Record and Questionnaire, the Thai version of the Athens Insomnia Scale (AIS-Thai) by Chalardsakul and Sithinamsuwan (2022), the Pregnancy-related Anxiety Scale by Pinanong et al. (2020), and the Thai version of the Dysfunctional Beliefs and Attitudes about Sleep Scale by Chimluang et al. (2017). Data were analyzed using descriptive statistics, Fisher's exact test, and multiple logistic regression. The results showed that: 1. Pregnant women with obesity had insomnia (AIS ≥ 7) at 44.35%. The median score for insomnia was 6.0 (IQR = 4.0). 2. The factors predicting insomnia among pregnant women with obesity included pre-pregnancy body mass index (BMI) ≥ 27.0 kg/m² (aOR = 3.05, 95% CI: 1.14-8.16), pregnancy-related anxiety with a score ≥ 19.0 (aOR = 2.88, 95% CI: 1.17-7.11), and dysfunctional beliefs and attitudes about sleep with a score ≥ 6.0 (aOR = 4.20, 95% CI: 1.51-11.64) with a prediction accuracy of 75.10% (AuROC = 0.751). The findings of this study suggest that nurse-midwives should assess pre-pregnancy BMI, pregnancy-related anxiety, and dysfunctional beliefs and attitudes about sleep in pregnant women with obesity to screen and monitor insomnia as well as promote sleep in pregnant women with obesity.