How Does Maternal Role Identity Affect Sleep in Early Pregnancy? — The Role of Coping Styles and Mental Health

Objective Sleep quality during early pregnancy significantly impacts adverse pregnancy outcomes, maternal and infant health, and fertility intentions. However, limited research has focused on pathways associated with sleep quality. Methods Early pregnancy women from a psychological clinic completed the Self-Identity Scale, the Simplified Coping Style Questionnaire, the Symptom Checklist-90 (SCL-90), and the Pittsburgh Sleep Quality Index (PSQI). Based on PSQI scores, sleep quality was categorized into four levels: excellent, good, fair, and poor. Differences among the levels were tested for balance, and structural equation modeling were used to examine associations among variables. Results Path analysis revealed: 1. Self-identity significantly positively predicted positive coping (β = 0.321) and mental health (β=-0.489), and significantly negatively predicted negative coping (β=-0.355). 2. Both positive and negative coping significantly predicted mental health (β=-0.207, β = 0.239, p<0.05). 3. Mental health significantly negatively predicted sleep quality (β=-0.280). Bootstrap tests confirmed mental health fully mediated the effects of positive coping (β = 0.058, 95%CI [0.010, 0.137]) and negative coping (β=-0.067, 95%CI [-0.191, -0.011]) on sleep quality; meanwhile, positive (β=-0.066, 95%CI [-0.164, -0.013]) and negative coping (β=-0.085, 95%CI [-0.255, -0.032]) partially mediated the self-identity and mental health relationship. Conclusion Among women in early pregnancy, self-identity influences mental health either directly or by shaping different coping styles, and mental health fully mediates the effect of coping styles on sleep quality. The findings provide a basis for sleep interventions targeting psychological adaptation during pregnancy. Future longitudinal studies are needed to further validate the temporal relationships and pathways among the variables.