Joint Trajectories of Depression, Anxiety, and Sleep Quality During Pregnancy and Their Risk Factors: A Prospective Longitudinal Study

¹ Nursing Department of Xinjiang Medical University, Urumqi 830017, Xinjiang Uygur Autonomous Region, China; Nursing Department of Xinjiang Second Medical College, Karamay 834000, Xinjiang Uygur Autonomous Region, China,

² The Third Department of Clinical Psychology, Karamay Integrated Traditional Chinese and Western Medicine Hospital (People’s Hospital of Karamay), Karamay 834000, Xinjiang Uygur Autonomous Region, China,

³ Xinjiang Production and Construction Corps Health Committee, Urumqi 830000, Xinjiang Uygur Autonomous Region, China,

⁴ Nursing Department of Xinjiang Second Medical College, Karamay 834000, Xinjiang Uygur Autonomous Region, China,

⁵ Nursing Department of Xinjiang Medical University, Urumqi 830017, Xinjiang Uygur Autonomous Region, China; Health Care Research Center for Xinjiang Regional Population, Urumqi 830000, Xinjiang Uygur Autonomous Region, China,

AOGR 2026 , 4(2), 5–18; https://doi.org/10.26689/aogr.v4i2.14704

© 2026 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

Objective: This study aimed to describe the joint trajectories of depression, anxiety, and sleep quality during pregnancy, identify at-risk trajectory populations, and identify their predictable risk factors. Methods: The sample consisted of 146 pregnant women who completed the pregnancy follow-up. Data were collected at four gestational time points. Parallel process latent class growth analysis (PP-LCGA) was employed to identify the synchronous trajectory patterns of depression, anxiety, and sleep quality. Multiple logistic regression models determined the risk factors associated with individuals exhibiting these vulnerable trajectories. Results: Three trajectories related to changes in depression, anxiety, and sleep quality during pregnancy were identified as follows: the stable asymptomatic group (34.2%), the general health group (43.8%), and the joint symptoms group (21.9%). The predictors of the joint symptoms group trajectory included abortion experience (OR = 2.366, 95% CI [1.153;4.856]), lower back pain during pregnancy (OR = 3.286, 95% CI [1.296;8.331]), and the impact of pregnancy on daily life (OR = 5.619, 95% CI [1.843;17.128]). Conclusions: There is heterogeneity in the trajectories of depression, anxiety, and sleep quality during pregnancy. Previous miscarriage, low back pain in the first trimester, and the impact of pregnancy on life were predictors in the combined trajectory group.

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