Sleep, anxiety, and preeclampsia: A correlational study in Banjarmasin
DOI:
https://doi.org/10.71357/hsij.v4i2.93Keywords:
Anxiety level, Sleep quality, Preeclampsia incidence, Pregnant women, Antenatal careAbstract
Background: Preeclampsia remains one of the leading causes of maternal morbidity and mortality worldwide. Emerging evidence suggests that psychological and behavioral factors, particularly anxiety and poor sleep quality, may contribute to the development of preeclampsia through neuroendocrine, inflammatory, and vascular mechanisms. However, evidence from primary healthcare settings in Indonesia remains limited.
Objective: This study aimed to analyze the correlation between anxiety level and sleep quality with the incidence of preeclampsia among pregnant women attending the Pekauman Public Health Centre, Banjarmasin.
Method: A quantitative analytical study with a cross-sectional design was conducted among 34 pregnant women with gestational age ≥20 weeks, selected using accidental (consecutive) sampling. Anxiety level was measured using the Hamilton Anxiety Rating Scale (HARS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while preeclampsia was determined based on blood pressure measurement and proteinuria examination. Data were analyzed using descriptive statistics and the Spearman Rank Correlation test with a significance level of p < 0.05.
Results: Among the respondents, 61.8% experienced mild anxiety, 47.1% had poor sleep quality, and 38.2% were diagnosed with preeclampsia. A statistically significant strong positive correlation was found between anxiety level and preeclampsia incidence (r = 0.780; p < 0.001). In addition, poor sleep quality demonstrated a statistically significant very strong positive correlation with preeclampsia incidence (r = 0.835; p < 0.001). Pregnant women with severe anxiety and poor sleep quality were more likely to develop preeclampsia than those with lower anxiety levels and good sleep quality.
Conclusion: Higher anxiety levels and poorer sleep quality were significantly associated with an increased incidence of preeclampsia among pregnant women.
Downloads
References
ACOG. (2019). ACOG practice bulletin no. 202: Gestational hypertension and preeclampsia. Obstetrics & Gynecology, 133(1), 1–1. https://doi.org/10.1097/AOG.0000000000003018
Aggarwal, B., Makarem, N., Shah, R., Emin, M., Wei, Y., St‐Onge, M., & Jelic, S. (2018). Effects of inadequate sleep on blood pressure and endothelial inflammation in women: findings from the American Heart Association go red for women strategically focused research Network. Journal of the American Heart Association, 7(12). https://doi.org/10.1161/JAHA.118.008590
Akbar, M. I. A., Gumilar, K. E., Aziz, M. A., Pribadi, A., Bachnas, M. A., Aryanda, R. A., & Dekker, G. (2025). Maternal death associated with preeclampsia in Indonesia. Pregnancy Hypertension, 42, 101400. https://doi.org/10.1016/j.preghy.2025.101400
Ashique, S., Khatun, T., & Sandhu, N. K. (2022). Withdrawn: Preeclampsia: Long term prognosis in mother and their children. Current Biotechnology, 12. https://doi.org/10.2174/2211550111666220615112432
Azkiatunnisak, K., & Wulandari, C. L. (2026). Literature review: The influence of stress and sleep patterns on the incidence of preeclampsia in pregnant women [in Indonesia]. Jurnal Kebidanan Besurek, 11(1), 18–27.
Georgiou, N., Fasoulakis, Z., Theodora, M., Pappas, V. A., Papamanolis, V., Kalagasidou, S., Blontzos, N., Kambas, N. J., & Kontomanolis, E. N. (2019). Association of pregestational maternal sleeping disorders and preeclampsia: A retrospective cohort study and review of the literature. Cureus. https://doi.org/10.7759/cureus.4338
Kırca, A. Ş., & Çetin, N. Ş. (2024). The effect of classical foot massage on insomnia and anxiety in preeclamptic pregnant women: A randomized controlled study. Revista Da Associação Médica Brasileira, 70(2). https://doi.org/10.1590/1806-9282.20230744
Liu, C.-H., Zhang, H.-Y., Wang, F., Mu, S.-S., & Wen, F.-Y. (2025). Anxiety and hypertensive disorders of pregnancy: Epidemiology, mechanisms, and management strategies. World Journal of Psychiatry, 15(6). https://doi.org/10.5498/wjp.v15.i6.105944
Malhamé, I., Bublitz, M. H., Wilson, D., Sanapo, L., Rochin, E., & Bourjeily, G. (2022). Sleep disordered breathing and the risk of severe maternal morbidity in women with preeclampsia: A population-based study. Pregnancy Hypertension, 30, 215–220. https://doi.org/10.1016/j.preghy.2022.10.013
Maniaci, A., Lavalle, S., Parisi, F. M., Barbanti, M., Cocuzza, S., Iannella, G., Magliulo, G., Pace, A., Lentini, M., Masiello, E., & La Via, L. (2024). Impact of obstructive sleep apnea and sympathetic nervous system on cardiac health: A comprehensive review. Journal of Cardiovascular Development and Disease, 11(7), 204. https://doi.org/10.3390/jcdd11070204
Miller, E. C. (2019). Preeclampsia and cerebrovascular disease. Hypertension, 74(1), 5–13. https://doi.org/10.1161/HYPERTENSIONAHA.118.11513
Neerukonda, S., Shariati, F., Hart, T., Stewart, M., Elkayam, U., & Qamruddin, S. (2020). Cardiovascular effects of preeclampsia. Current Opinion in Cardiology, 35(4), 357–359. https://doi.org/10.1097/HCO.0000000000000756
Parise, B. K., Ferreira, N. L., & Drager, L. F. (2023). The cardiovascular impact of obstructive sleep apnea in women. Sleep Medicine Clinics, 18(4), 473–480. https://doi.org/10.1016/j.jsmc.2023.06.008
Pivato, C. A., Inversetti, A., Cristodoro, M., Latini, A. C., Condorelli, G., Stefanini, G., & De Simone, N. (2023). Long-term cardiovascular risk of pre-eclampsia. European Heart Journal, 44(Supplement_2). https://doi.org/10.1093/eurheartj/ehad655.2642
Querejeta Roca, G., Anyaso, J., Redline, S., & Bello, N. A. (2020). Associations between sleep disorders and hypertensive disorders of pregnancy and materno-fetal consequences. Current Hypertension Reports, 22(8), 53. https://doi.org/10.1007/s11906-020-01066-w
Savka, R., & Berbets, A. (2023). Sleep disorders and changes in melatonin concentrations in pregnant women with preeclampsia. Cell and Organ Transplantology, 11(2). https://doi.org/10.22494/cot.v11i2.158
Soundararajan, S., Madora, M., Hatten-Powell, C., & Vaughn, R. (2025). Examining the relationship between maternal anxiety symptoms; hypertensive disorders of pregnancy. Current Treatment Options in Psychiatry, 12(1), 30. https://doi.org/10.1007/s40501-025-00365-w
Torres, G., Sánchez de la Torre, M., Pinilla, L., & Barbé, F. (2024). Obstructive sleep apnea and cardiovascular risk. Clínica e Investigación En Arteriosclerosis (English Edition), 36(4), 234–242. https://doi.org/10.1016/j.artere.2024.07.003
Umam, M. H., Dewi, M. I., & Sukarsa, M. R. A. (2026). Correlation between first-trimester anemia in pregnancy and the incidence of preeclampsia: A retrospective cohort study. Indonesian Journal of Obstetrics & Gynecology Science, 9(2), 280. https://doi.org/10.24198/obgynia.v9i2.1176
Vianna, P., Bauer, M. E., Dornfeld, D., & Chies, J. A. B. (2011). Distress conditions during pregnancy may lead to pre-eclampsia by increasing cortisol levels and altering lymphocyte sensitivity to glucocorticoids. Medical Hypotheses, 77(2), 188–191. https://doi.org/10.1016/j.mehy.2011.04.007
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Rizka Novia Rhamadayanti Rizka, latifah, windaa

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Health Sciences International Journal (HSIJ) © 2023 by Ananda Health and Education Foundation is licensed under Attribution-ShareAlike 4.0 International
Deprecated: json_decode(): Passing null to parameter #1 ($json) of type string is deprecated in /var/www/html/plugins/generic/citations/CitationsPlugin.php on line 68






