ArticleBMC women's health2025
Association between parity and female depression: the mediative role of sleep duration.
Article in BMC women's health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Interpregnancy interval and maternal postpartum depression and anxiety: findings from the APrON cohort.European journal of public health · 2026Article
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5 authors.
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Abstract
backgroundThis cross-sectional study aimed to investigate whether parity is associated with depressive symptoms among women, and whether sleep duration mediates this association.
methodsOur analytical sample comprised 14,493 female participants drawn from six consecutive NHANES cycles (2007–2018). Parity status was ascertained through structured self-administered questionnaires, while depressive symptoms were quantified using the validated nine-item Patient Health Questionnaire (PHQ-9) with a standardized cutoff score ≥ 10 indicating clinically significant symptoms. We employed multivariable-adjusted logistic regression models to evaluate the parity-depression association, complemented by restricted cubic spline (RCS) regression to assess non-linear dose-response relationships. A mediation analysis framework was implemented to quantify sleep duration’s potential intermediary role, supported by multiple sensitivity analyses to verify result robustness.
resultsThe analysis revealed a non-linear dose-response relationship (inverted L-shape) between parity and depressive symptoms. Compared to nulliparous women after full covariate adjustment, primiparous and multiparous women demonstrated significantly elevated risks: those with 1–3 live births showed a 46% increased risk (Odds Ratio (OR) = 1.46, 95%CI 1.17–1.82, p = 0.001), while women with ≥ 4 births exhibited a 63% higher risk (OR = 1.63, 95%CI 1.26–2.11, p < 0.001). The subgroup analyses identified significant effect modification by both age category (p-interaction = 0.002) and race (p-interaction = 0.03).Mediation models estimated that sleep duration accounted for 12.86% of the total parity-depression association.
conclusionThere is a non-linear, dose-dependent association between parity and depressive symptoms, and sleep duration was identified as a partial statistical mediator. These findings underscore the need for integrating parity assessment and perinatal sleep management into depression prevention strategies.
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