Socio-Demographic and Behavioral Determinants of Poor Sleep Quality in Third-Trimester Pregnancy: A Study from Central Brazil

Abstract Objective To evaluate the prevalence of poor sleep quality and identify its associated factors among third-trimester pregnant women attending a public healthcare service in a municipality in Goiás, Brazil. Methods This was a cross-sectional, analytical, and epidemiological study conducted with a probabilistic sample of 243 pregnant women. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), along with sociodemographic, behavioral, health, sexual, and pregnancy-related variables. Data were analyzed using Poisson regression with robust variance to estimate prevalence ratios (PR) and their respective 95% confidence intervals (95% CI), with a significance level of 5% ( p < 0.05). Results The prevalence of poor sleep quality was 24.7%. Multivariate analysis identified non-white race/color (PR = 4.30; 95% CI 1.48–12.56), unemployment (PR = 3.07; 95%CI 1.23–7.63), and not engaging in physical activity (PR = 3.28; 95% CI 1.37–7.83) as independent predictors of poor sleep quality. Additionally, excessive daytime sleepiness (PR = 3.48; 95% CI 1.55–7.82) and high risk of stress (PR = 2.71; 95% CI 1.09–6.75) were also significantly associated with the outcome. Conclusion Poor sleep quality is a highly prevalent issue in the studied population and is strongly associated with sociodemographic and behavioral factors. These findings highlight the importance of integrating into prenatal care interventions that address the social determinants of health.