系統識別號 U0026-0702201714274600
論文名稱(中文) 印尼高危險妊娠婦女睡眠品質及其相關因素之探討
論文名稱(英文) Sleep quality and associated factors among Indonesian women with high risk pregnancy
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 105
學期 1
出版年 106
研究生(中文) 魏嘉怡
研究生(英文) Yosi Maria Wijaya
學號 T26047027
學位類別 碩士
語文別 英文
論文頁數 59頁
口試委員 指導教授-周承珍
中文關鍵字 none 
英文關鍵字 sleep quality  high risk pregnancy 
中文摘要 none
英文摘要 Background: Pregnant women generally experience poor sleep quality. However, the majority of research on this topic has been conducted on sleep quality in women with normal pregnancy. Few studies of sleep quality have focused on women with high-risk pregnancy, and no study on sleep quality among high risk pregnant women in Indonesia have been conducted.
Objective: To investigated sleep quality and associated factors among women with high-risk pregnancy in Indonesia.
Methods: This was a cross sectional study with a convenience sample. 144 women with high risk pregnancy were recruited from a prenatal clinic in a private hospital, West Java, Indonesia, screened according to high-risk pregnancy, gestational age ≥ 20 weeks. Data were collected using four instruments: demographic questionnaire, Pittsburgh Sleep Quality Index, Beck Depression Inventory, and a State Trait Anxiety Inventory.
Results: The participants in this study were married, the average age was 28.92 years old (SD = 6.04), most of them unemployed (78%). More than half (86.8%) of pregnant women scored 6 in high risk severity with mean gestational age was 27.67 ± 5.59 weeks. The frequent criteria of high risk pregnancies among participants were hypertension (39.6%), anemia (33.3%) and birth interval less than 2 years (17.4%). The global score of sleep quality was 6.36 (SD= 3.01). More than half of the participants (56.9%) reported poor sleep quality (PSQI >5). Sleep quality was predicted by educational years, gestational age and depression, accounting for 28.2% of the total variance.
Conclusion: Women with high risk pregnancy with more years of education, longer gestational age and higher levels of depression experience poor sleep quality. Further research is needed to assess sleep quality with a longitudinal approach and develop interventions that will improve sleep quality in women with high risk pregnancy.
Relevance to clinical practice: Understanding the sleep quality and associated factors contributes to health care providers’ ability to design effective treatments intended to improve sleep quality in order to prevent women with high risk pregnancy from adverse birth outcomes.
1.1 Research Background. 1
1.2 Significance 2
1.3 Research Purpose 3
2.1 Pregnancy 4
2.1.1 Normal pregnancy 4
2.2 High-risk pregnancy 6
2.2.1 Definition of high-risk pregnancy 6
2.2.2 Prevalence of high-risk pregnancy 7
2.2.3 Impact of high-risk pregnancy 7
2.2.4 Risk factors for high-risk pregnancy 8
2.2.5 How to measure high-risk pregnancy 9
2.3 Sleep quality 10
2.3.1 Sleep 10
2.3.2 Sleep during pregnancy 13
3.1 Research Design 18
3.2 Research framework 18
3.3 Operational Definition 19
3.4 Population and sample 19
3.5 Instrument 20
3.6 Pilot study 23
3.7 Data collection procedures 23
3.8 Data Analysis 24
4.1 Sample characteristics 26
4.2 Sleep quality 28
4.3 Factors correlated with sleep quality 30
4.4 Predictors of sleep quality 32
5.1 Discussion 33
5.2 Limitation 36
5.3 Conclusion 37
5.4 Nursing Implications 37
Appendix 1 Demographic & Maternal Related Factors Questionnaire 46
Appendix 2 Pittsburgh Sleep Quality Index (PSQI) 47
Appendix 3 PSQI Questionnaire Permission 50
Appendix 4 State Trait Anxiety Inventory (STAI) 51
Appendix 5 STAI Questionnaire Permission 53
Appendix 6 Beck Depression Inventory (BDI) 54
Appendix 7 BDI Questionnaire Permission 55
Appendix 8 Informed Consent 56
Appendix 9 Ethical Clearance Document 58
Appendix 10 Research Permission Approval Document 59
參考文獻 Adouard, F., Glangeaud-Freudenthal, N., & Golse, B. (2005). Validation of the Edinburgh postnatal depression scale (EPDS) in a sample of women with high-risk pregnancies in France. Archives of Women’s Mental Health, 8(2), 89-95.
Afrasiabi, N., Mohagheghi, P., Kalani, M., Mohades, G., & Farahani, Z. (2014). The effect of high risk pregnancy on duration of neonatal stay in neonatal intensive care unit. Iranian Journal of Pediatrics, 24(4), 423.
Analen, C. (2007). Saving mother's lives in rural Indonesia. Bulletin of the World Health Organization, 85(10), 740-741.
Beebe, K. R., & Lee, K. A. (2007). Sleep disturbance in late pregnancy and early labor. The Journal of Perinatal & Neonatal Nursing, 21(2), 103-108.
Beck, A. T., Steer, R. A., & Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77-100.
Beck, A. T., Ward, C.H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An Inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
Benitez, A., & Gunstad, J. (2012). Poor sleep quality diminishes cognitive functioning independent of depression and anxiety in healthy young adults. The Clinical Neuropsychologist, 26(2), 214-223.
Bhattacharya, S., Prescott, G. J., Iversen, L., Campbell, D., Smith, W. C. S., & Hannaford, P. C. (2012). Hypertensive disorders of pregnancy and future health and mortality: a record linkage study. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2(1), 1-7.
Blair, L., Porter, K., Leblebicioglu, B., & Christian, L. (2015). Poor sleep quality and associated inflammation predict preterm birth: Heightened risk among African Americans. Sleep, 38(8), 1259-1267. Bope, E. T., & Kellerman, R. D. (2015). Conn's Current Therapy 2016: Elsevier Health Sciences.
Brandon, A. R., Trivedi, M. H., Hynan, L. S., Miltenberger, P. D., Labat, D. B., Rifkin, J. B., & Stringer, C. A. (2008). Prenatal depression in women hospitalized for obstetric risk. The Journal of Clinical Psychiatry, 69(4), 635.
Bublitz, M. H., Bourjeily, G., D’Angelo, C., & Stroud, L. R. (2016). Maternal sleep quality and diurnal cortisol regulation over pregnancy. Behavioral Sleep Medicine, 1-14.
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213.
Byatt, N., Hicks-Courant, K., Davidson, A., Levesque, R., Mick, E., Allison, J., & Simas, T. A. M. (2014). Depression and anxiety among high-risk obstetric inpatients. General Hospital Psychiatry, 36(6), 644-649.
Carlin, A., & Alfirevic, Z. (2008). Physiological changes of pregnancy and monitoring. Best Practice & Research Clinical Obstetrics & Gynaecology, 22(5), 801-823.
Carlo, W. A., & Ambalavanan, N. (2016). High-risk pregnancies. In R. M Kliegman, Nelson Textbook of Pediatrics (pp. 802-806.e1). Elsevier, Inc.
Cirelli, C., & Tononi, G. (2008). Is sleep essential? PLoS Biology, 6(8), e216. Çoban, A., & Yanıkkerem, U. (2010). Sleep quality and fatigue in pregnant women. Ege Journal of Medicine, 49(2), 87-94.
Çoban, A., & Yanıkkerem, U. (2010). Sleep quality and fatigue in pregnant women. Ege Journal of Medicine, 49(2), 87-94
Coco, L., Giannone, T., & Zarbo, G. (2014). Management of high-risk pregnancy. Minerva ginecologica, 66(4), 383-389.
Costa, S. L., Proctor, L., Dodd, J. M., Toal, M., Okun, N., Johnson, J.-A., Kingdom, J. C. (2008). Screening for placental insufficiency in high-risk pregnancies: is earlier better? Placenta, 29(12), 1034-1040.
de La Rochebrochard, E., & Thonneau, P. (2002). Paternal age and maternal age are risk factors for miscarriage; results of a multicentre European study. Human Reproduction, 17(6), 1649-1656.
Dixon, C. L. (2014). Sleep deprivation & pregnancy related risks. International Journal of Childbirth Education, 29(3).
Dolea, C., & AbouZahr, C. (2003). Global burden of hypertensive disorders of pregnancy in the year 2000.
Dulude, D., Belanger, C., Wright, J., & Sabourin, S. (2002). High-risk pregnancies, psychological distress, and dyadic adjustment. Journal of Reproductive and Infant Psychology, 20(2), 101-123.
Dzaja, A., Arber, S., Hislop, J., Kerkhofs, M., Kopp, C., Pollmächer, T., Tobler, I. (2005). Women's sleep in health and disease. Journal of Psychiatric Research, 39(1), 55-76.
Facco, F. L., Grobman, W. A., Kramer, J., Ho, K. H., & Zee, P. C. (2010). Self-reported short sleep duration and frequent snoring in pregnancy: Impact on glucose metabolism. American journal of obstetrics and gynecology, 203(2),
Facco, F. L., Kramer, J., Ho, K. H., Zee, P. C., & Grobman, W. A. (2010). Sleep disturbances in pregnancy. Obstetrics & Gynecology, 115(1), 77-83.
Ferrie, J. E., Kivimäki, M., Akbaraly, T. N., Singh-Manoux, A., Miller, M. A., Gimeno, D., Shipley, M. J. (2013). Associations between change in sleep duration and inflammation: findings on C-reactive protein and interleukin 6 in the Whitehall II Study. American Journal of Epidemiology, 178(6), 956-961.
Field, T., Diego, M., Hernandez-Reif, M., Figueiredo, B., Schanberg, S., & Kuhn, C. (2007). Sleep disturbances in depressed pregnant women and their newborns. Infant Behavior and Development, 30(1), 127-133.
Fleischman, A. R., Oinuma, M., & Clark, S. L. (2010). Rethinking the definition of “term pregnancy”. Obstetrics & Gynecology, 116(1), 136-139.
Fraigne, J. J., Grace, K. P., Horner, R. L., & Peever, J. (2014). Mechanisms of REM sleep in health and disease. Current Opinion in Pulmonary Medicine, 20(6), 527-532.
Fuller, P. M., Gooley, J. J., & Saper, C. B. (2006). Neurobiology of the sleep-wake cycle: sleep architecture, circadian regulation, and regulatory feedback. Journal of Biological Rhythms, 21(6), 482-493.
Funai, E. F., Friedlander, Y., Paltiel, O., Tiram, E., Xue, X., Deutsch, L., & Harlap, S. (2005). Long-term mortality after preeclampsia. Epidemiology, 16(2), 206-215.
Gelaye, B., Barrios, Y. V., Zhong, Q.-Y., Rondon, M. B., Borba, C. P., Sánchez, S. E., Williams, M. A. (2015). Association of poor subjective sleep quality with suicidal ideation among pregnant Peruvian women. General Hospital Psychiatry, 37(5), 441-447.
Gilbert, E. S. (2010). Manual of High Risk Pregnancy and Delivery: Elsevier Health Sciences.
Ginting, H., Näring, G., van der Veld, W. M., Srisayekti, W., & Becker, E. S. (2013). Validating the Beck Depression Inventory-II in Indonesia's general population and coronary heart disease patients. International Journal of Clinical and Health Psychology, 13(3), 235.
Ginting, H., Näring, G., Kwakkenbos, L., & Becker, E. S. (2015). Spirituality and negative emotions in individuals with coronary heart disease. Journal of Cardiovascular Nursing, 30(6), 537-545.
Goyal, D., Gay, C. L., & Lee, K. A. (2007). Patterns of sleep disruption and depressive symptoms in new mothers. The Journal of Perinatal & Neonatal Nursing, 21(2), 123-129.
Grant, K. A., McMahon, C., & Austin, M. P. (2008). Maternal anxiety during the transition to parenthood: a prospective study. Journal of affective disorders, 108(1), 101-111.
Haack, M., Sanchez, E., & Mullington, J. M. (2007). Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers. Sleep, 30(9), 1145.
Hall, W. A., Hauck, Y. L., Carty, E. M., Hutton, E. K., Fenwick, J., & Stoll, K. (2009). Childbirth fear, anxiety, fatigue, and sleep deprivation in pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38(5), 567-576.
Hapsari, D., Dharmayanti, I., & Kusumawardani, N. (2014). Faktor-faktor yang berpengaruh terhadap risiko kehamilan “4 terlalu (4-T)” pada wanita usia 10-59 tahun (Analisis Riskesdas 2010). Media Penelitian dan Pengembangan Kesehatan, 24(3 Sep), 143-152.
Hayase, M., Shimada, M., & Seki, H. (2014). Sleep quality and stress in women with pregnancy-induced hypertension and gestational diabetes mellitus. Women and Birth, 27(3), 190-195.
Hedman, C., Pohjasvaara, T., Tolonen, U., Suhonen-Malm, A., & Myllylä, V. V. (2002). Effects of pregnancy on mothers' sleep. Sleep Medicine, 3(1), 37-42.
Henry, J. D., & Rendell, P. G. (2007). A review of the impact of pregnancy on memory function. Journal of Clinical and Experimental Neuropsychology, 29(8), 793-803.
Heron, J., O'Connor, T. G., Evans, J., Golding, J., Glover, V., & Team, A. S. (2004). The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affective Disorders, 80(1), 65-73.
Hung, H.-M., Tsai, P.-S., Ko, S.-H., & Chen, C.-H. (2013). Patterns and predictors of sleep quality in Taiwanese pregnant women. MCN: The American Journal of Maternal/Child Nursing, 38(2), 95-101.
Hutchison, B. L., Stone, P. R., McCowan, L. M., Stewart, A. W., Thompson, J. M., & Mitchell, E. A. (2012). A postal survey of maternal sleep in late pregnancy. BMC pregnancy and childbirth, 12(1), 1.
Indonesia, S. (2012). National Population and Family Planning Board (BKKBN), and Kementerian Kesehatan (Kemenkes—MOH), and ICF International. 2013. Indonesia Demographic and Health Survey 2012.
Iversen, L., & Hannaford, P. C. (2010). Toxaemia of pregnancy and risk of mortality in later life: Evidence from the royal college of general practitioners' oral contraception study. Hypertension in Pregnancy, 29(2), 180-197.
Izci-Balserak, B., & Lee, K. (2010). Sleep disturbances and sleep-related disorders in pregnancy. Principles and practice of sleep medicine, 5, 1572-1586.
Izci, B., Martin, S. E., Dundas, K. C., Liston, W. A., Calder, A. A., & Douglas, N. J. (2005). Sleep complaints: snoring and daytime sleepiness in pregnant and pre-eclamptic women. Sleep Medicine, 6(2), 163-169.
Jomeen, J., & Martin, C. R. (2007). Assessment and relationship of sleep quality to depression in early pregnancy. Journal of Reproductive and Infant Psychology, 25(1), 87-99.
Jones, R. E., & Lopez, K. H. (2013). Human Reproductive Biology: Academic Press.
Kennelly, M., Fallon, A., Farah, N., Stuart, B., & Turner, M. (2011). Effects of body mass index on sleep patterns during pregnancy. Journal of Obstetrics and Gynaecology, 31(2), 125-127.
Kent, R. G., Uchino, B. N., Cribbet, M. R., Bowen, K., & Smith, T. W. (2015). Social relationships and sleep quality. Annals of Behavioral Medicine, 49(6), 912-917.
Kilpatrick, S., & Garite, T. (2011). High-risk pregnancy care, research, and education for over 35 years. Society of Maternal Fetal Medicine and the SMFM Foundation, 1-32.
Kızılırmak, A., Timur, S., & Kartal, B. (2012). Insomnia in pregnancy and factors related to insomnia. The Scientific World Journal, 2012.
Ko, S. H., Chang, S. C., & Chen, C. H. (2010). A comparative study of sleep quality between pregnant and nonpregnant Taiwanese women. Journal of Nursing Scholarship, 42(1), 23-30.
Ko, Y. L., Lin, P. C., & Chen, S. C. (2015). Stress, sleep quality and unplanned Caesarean section in pregnant women. International journal of nursing practice, 21(5), 454-461.
Krystal, A. D., & Edinger, J. D. (2008). Measuring sleep quality. Sleep Medicine, 9, S10-S17.
Lee, K. A., & Gay, C. L. (2004). Sleep in late pregnancy predicts length of labor and type of delivery. American Journal of Obstetrics and Gynecology, 191(6), 2041-2046.
Lee, K. A., Zaffke, M. E., & McEnany, G. (2000). Parity and sleep patterns during and after pregnancy. Obstetrics & Gynecology, 95(1), 14-18.
Leung, P. L., Hui, D. S. C., Leung, T. N., Yuen, P. M., & Lau, T. K. (2005). Sleep disturbances in Chinese pregnant women. BJOG: An International Journal of Obstetrics & Gynaecology, 112(11), 1568-1571.
Levy-Shiff, R., Lerman, M., Har-Even, D., & Hod, M. (2002). Maternal adjustment and infant outcome in medically defined high-risk pregnancy. Developmental psychology, 38(1), 93.
Li, G., Kong, L., Zhou, H., Kang, X., Fang, Y., & Li, P. (2016). Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience. Sleep Medicine, 25, 8-12.
Littleton, H. L., Breitkopf, C. R., & Berenson, A. B. (2007). Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: a meta-analysis. American journal of Obstetrics and Gynecology, 196(5), 424-432.
Markov, D., & Goldman, M. (2006). Normal sleep and circadian rhythms: neurobiologic mechanisms underlying sleep and wakefulness. Psychiatric Clinics of North America, 29(4), 841-853.
Mellor, R., Chua, S., & Boyce, P. (2014). Antenatal depression: an artefact of sleep disturbance? Archives of Women's Mental Health, 17(4), 291-302.
Mindell, J. A., Cook, R. A., & Nikolovski, J. (2015). Sleep patterns and sleep disturbances across pregnancy. Sleep medicine, 16(4), 483-488.
Mindell, J. A., & Jacobson, B. J. (2000). Sleep disturbances during pregnancy. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 29(6), 590-597.
Moline, M. L., Broch, L., Zak, R., & Gross, V. (2003). Sleep in women across the life cycle from adulthood through menopause. Sleep Medicine Reviews, 7(2), 155-177.
Monga, M. (2009). Maternal cardiovascular, respiratory, and renal adaptation to pregnancy. Creasy and Resnik’s Maternal–Fetal Medicine: Principles and Practice. 6th ed. Philadelphia: Saunders Elsevier.
Naghi, I., Keypour, F., Ahari, S., Tavalai, S., & Khak, M. (2011). Sleep disturbance in late pregnancy and type and duration of labour. Journal of Obstetrics and Gynaecology, 31(6), 489-491.
Nagl, M., Linde, K., Stepan, H., & Kersting, A. (2015). Obesity and anxiety during pregnancy and postpartum: A systematic review. Journal of Affective Disorders, 186, 293-305.
Nour, N. M. (2008). An introduction to maternal mortality. Reviews in Obstetrics and Gynecology, 1(2), 77.
O'Hara, M. W., & Wisner, K. L. (2014). Perinatal mental illness: definition, description and aetiology. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 3-12.
Okun, M. L., Kiewra, K., Luther, J. F., Wisniewski, S. R., & Wisner, K. L. (2011). Sleep disturbances in depressed and nondepressed pregnant women. Depression and anxiety, 28(8), 676-685.
Okun, M. L., Kline, C. E., Roberts, J. M., Wettlaufer, B., Glover, K., & Hall, M. (2013). Prevalence of sleep deficiency in early gestation and its associations with stress and depressive symptoms. Journal of Women's Health, 22(12), 1028-1037.
Okun, M. L., Luther, J., Prather, A. A., Perel, J. M., Wisniewski, S., & Wisner, K. L. (2011). Changes in sleep quality, but not hormones predict time to postpartum depression recurrence. Journal of Affective Disorders, 130(3), 378-384.
Okun, M. L., Luther, J. F., Wisniewski, S. R., Sit, D., Prairie, B. A., & Wisner, K. L. (2012). Disturbed sleep, a novel risk factor for preterm birth? Journal of Women's Health, 21(1), 54-60.
Okun, M. L., Schetter, C. D., & Glynn, L. M. (2011). Poor sleep quality is associated with preterm birth. Sleep, 34(11), 1493-1498.
Okun, M. L., Tolge, M., & Hall, M. (2014). Low socioeconomic status negatively affects sleep in pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 43(2), 160-167.
Oran, N. T., Bilge, A., Can, H. Ö., Koçak, Y. Ç., Demirelöz, M., Karslıoğlu, S., & Soğukpınar, N. (2014). Influence of prenatal risks of pregnant women on mental symptoms. Anatolian Journal of Psychiatry, 15(2), 157-164.
Ouzounian, J. G., & Elkayam, U. (2012). Physiologic changes during normal pregnancy and delivery. Cardiology Clinics, 30(3), 317-329.
Owais, A., Faruque, A. S. G., Das, S. K., Ahmed, S., Rahman, S., & Stein, A. D. (2013). Maternal and antenatal risk factors for stillbirths and neonatal mortality in rural Bangladesh: a case-control study. PloS One, 8(11), e80164.
Oyetakin‐White, P., Suggs, A., Koo, B., Matsui, M., Yarosh, D., Cooper, K., & Baron, E. (2015). Does poor sleep quality affect skin ageing? Clinical and Experimental Dermatology, 40(1), 17-22.
Palagini, L., Gemignani, A., Banti, S., Manconi, M., Mauri, M., & Riemann, D. (2014). Chronic sleep loss during pregnancy as a determinant of stress: impact on pregnancy outcome. Sleep Medicine, 15(8), 853-859.
Pillitteri, A. (2010). Maternal & Child Health Nursing: Care of the Childbearing & Childrearing Family: Lippincott Williams & Wilkins.
Porkka‐Heiskanen, T., Zitting, K. M., & Wigren, H. K. (2013). Sleep, its regulation and possible mechanisms of sleep disturbances. Acta Physiologica, 208(4), 311-328.
Potti, S., Jain, N. J., Mastrogiannis, D. S., & Dandolu, V. (2012). Obstetric outcomes in pregnant women with diabetes versus hypertensive disorders versus both. The Journal of Maternal-Fetal & Neonatal Medicine, 25(4), 385-388.
Reichner, C. A. (2015). Insomnia and sleep deficiency in pregnancy. Obstetric Medicine: The Medicine of Pregnancy, 1753495X15600572.
Reid, J., Skomro, R., Cotton, D., Ward, H., Olatunbosun, F., Gjevre, J., & Guilleminault, C. (2011). Pregnant women with gestational hypertension may have a high frequency of sleep disordered breathing. Sleep, 34(8), 1033-1038.
Rezaei, E., Moghadam, Z. B., & Saraylu, K. (2013). Quality of life in pregnant women with sleep disorder. Journal of Family & Reproductive Health, 7(2), 87.
Rice, J. R., Larrabure-Torrealva, G. T., Fernandez, M. A. L., Grande, M., Motta, V., Barrios, Y. V., Williams, M. A. (2015). High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women. BMC Pregnancy and Childbirth, 15(1), 1.
Rochjati, P., Prabowo, P., Abahdi, A., Soegianto, B., Yahya, K., & Kwast, B. (1995). An antenatal risk scoring system: East Java safe motherhood study Probolinggo district East Java Indonesia. MOTHERCARE MATTERS, 5(1), 12-15.
Ruiz-Robledillo, N., Canário, C., Dias, C., Moya-Albiol, L., & Figueiredo, B. (2015). Sleep during the third trimester of pregnancy: the role of depression and anxiety. Psychology, Health & Medicine, 20(8), 927-932.
Ruiz, G. I., Valenza, M., Molina, C. M., Torres, S. I., Cabrera, M. I., & Gonzalez-Jimenez, E. (2014). [Sleep disturbances and gestational diabetes prevalence on last trimester of pregnancy]. Nutricion Hospitalaria, 32(3), 1139-1144.
Sahlin, C., Franklin, K. A., Stenlund, H., & Lindberg, E. (2009). Sleep in women: normal values for sleep stages and position and the effect of age, obesity, sleep apnea, smoking, alcohol and hypertension. Sleep Medicine, 10(9), 1025-1030.
Saper, C. B., Chou, T. C., & Scammell, T. E. (2001). The sleep switch: hypothalamic control of sleep and wakefulness. Trends in Neurosciences, 24(12), 726-731.
Seoud, M., Nassar, A. H., Usta, I. M., Melhem, Z., Kazma, A., & Khalil, A. M. (2002). Impact of advanced maternal age on pregnancy outcome. American Journal of Perinatology, 19(1), 1-8.
Sharvit, M., Rubinstein, T., Ravid, D., Shechter-Maor, G., Fishman, A., & Biron-Shental, T. (2014). Patients with high-risk pregnancies and complicated deliveries have an increased risk of maternal postpartum readmissions. Archives of Gynecology and Obstetrics, 290(4), 629-633.
Shields, M., Connor Gorber, S., & Tremblay, M. (2008). Associations between obesity and morbidity: effects of measurement methods. Obesity Reviews, 9(5), 501-502.
Siega-Riz, A.-M., & Laraia, B. (2006). The implications of maternal overweight and obesity on the course of pregnancy and birth outcomes. Maternal and Child Health Journal, 10(1), 153-156.
Sittner, B. J., DeFrain, J., & Hudson, D. B. (2005). Effects of high-risk pregnancies on families. MCN: The American Journal of Maternal/Child Nursing, 30(2), 121-126.
Situmorang, A. (2003). Adolescent reproductive health in Indonesia. Jakarta: Johns Hopkins University.
Skouteris, H., Wertheim, E. H., Germano, C., Paxton, S. J., & Milgrom, J. (2009). Assessing sleep during pregnancy: a study across two time points examining the Pittsburgh Sleep Quality Index and associations with depressive symptoms. Women's Health Issues, 19(1), 45-51.
Soltani, M., Haytabakhsh, M. R., Najman, J. M., Williams, G. M., O’Callaghan, M. J., Bor, W., Clavarino, A. (2012). Sleepless nights: the effect of socioeconomic status, physical activity, and lifestyle factors on sleep quality in a large cohort of Australian women. Archives of Women's Mental Health, 15(4), 237-247.
Sun, L., Yue, H., Sun, B., Han, L., Tian, Z., Qi, M., Fan, Y. (2014). Estimation of high risk pregnancy contributing to perinatal morbidity and mortality from a birth population-based regional survey in 2010 in China. BMC Pregnancy and Childbirth, 14(1), 1.
Suresh, K., & Chandrashekara, S. (2012). Sample size estimation and power analysis for clinical research studies. Journal of Human Reproductive Sciences, 5(1), 7.
Swick, T. J. (2011). The neurology of sleep. Sleep Medicine Clinics, 6(1), 1-14.
Tham, E. K., Tan, J., Chong, Y.-S., Kwek, K., Saw, S.-M., Teoh, O.-H., Broekman, B. F. (2016). Associations between poor subjective prenatal sleep quality and postnatal depression and anxiety symptoms. Journal of Affective Disorders, 202, 91-94.
Thiagayson, P., Krishnaswamy, G., Lim, M. L., Sung, S. C., Haley, C. L., Fung, D. S. S., Chen, H. (2013). Depression and anxiety in Singaporean high-risk pregnancies prevalence and screening. General Hospital Psychiatry, 35(2), 112-116.
Tibbitts, G. M. (2008). Sleep disorders: causes, effects, and solutions. Primary Care: Clinics in Office Practice, 35(4), 817-837.
Torricelli, M., Voltolini, C., De Bonis, M., Vellucci, F. L., Conti, N., Severi, F. M., & Petraglia, F. (2012). The identification of high risk pregnancy: a new challenge in obstetrics. The Journal of Maternal-Fetal & Neonatal Medicine, 25(sup1), 2-5.
Tsai, S.-Y., Kuo, L.-T., Lai, Y.-H., & Lee, C.-N. (2011). Factors associated with sleep quality in pregnant women: a prospective observational study. Nursing research, 60(6), 405-412.
Tsai, S.-Y., Lin, J.-W., Kuo, L.-T., & Thomas, K. A. (2012). Daily sleep and fatigue characteristics in nulliparous women during the third trimester of pregnancy. Sleep, 35(2), 257-262.
Tsai, S. Y., Lee, C. N., Wu, W. W., & Landis, C. A. (2016). Sleep Hygiene and Sleep Quality of Third‐Trimester Pregnant Women. Research in Nursing & Health, 39(1), 57-65.
Tsuno, N., Besset, A., & Ritchie, K. (2005). Sleep and depression. Journal of Clinical Psychiatry, 66(10), 1254-1269.
Veeraswamy, S., Vijayam, B., Gupta, V. K., & Kapur, A. (2012). Gestational diabetes: the public health relevance and approach. Diabetes Research and Clinical Practice, 97(3), 350-358.
Volkovich, E., Tikotzky, L., & Manber, R. (2015). Objective and subjective sleep during pregnancy: links with depressive and anxiety symptoms. Archives of Women's Mental Health, 1-9.
Wells, R. D., Day, R. C., Carney, R. M., Freedland, K. E., & Duntley, S. P. (2004). Depression predicts self-reported sleep quality in patients with obstructive sleep apnea. Psychosomatic Medicine, 66(5), 692-697.
WHO, U. (2012). UNFPA, The World Bank. Trends in maternal mortality: 1990 to 2010. World Health Organization, UNICEF, UNFPA, and The World Bank.
Yucel, S. C., Yucel, U., Gulhan, I., & Ozeren, M. (2012). Sleep quality and related factors in pregnant women. Journal of Medicine and Medical Sciences, 3(7), 459-463.
Zafarghandi, N., Hadavand, S., Davati, A., Mohseni, S. M., Kimiaiimoghadam, F., & Torkestani, F. (2012). The effects of sleep quality and duration in late pregnancy on labor and fetal outcome. The Journal of Maternal-Fetal & Neonatal Medicine, 25(5), 535-537.
Zareen, N., Naqvi, S., Majid, N., & Fatima, H. (2009). Perinatal outcome in high risk pregnancies. Journal of the College Physicians Surgeons Pakistan, 19(7), 432-435.
Zeitlhofer, J., Schmeiser‐Rieder, A., Tribl, G., Rosenberger, A., Bolitschek, J., Kapfhammer, G., Popovic, R. (2000). Sleep and quality of life in the Austrian population. Acta Neurologica Scandinavica, 102(4), 249-257.
  • 同意授權校內瀏覽/列印電子全文服務,於2020-02-08起公開。
  • 同意授權校外瀏覽/列印電子全文服務,於2020-02-08起公開。

  • 如您有疑問,請聯絡圖書館