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Background: Sleep is a vital requirement during pregnancy for the betterment of the fetus and the mother. Sleep quality could vary due to pregnancy-specific psychological and physiological changes. To introduce a tailored programme to enhance the sleep quality of mothers, it is paramount to assess the sleep quality and determinants of sleep. Therefore, this study aimed to assess the determinants of sleep quality among pregnant women in a selected institution in the Southern province of Sri Lanka. Methods: Hospital-based cross-sectional study was carried out with 245 antenatal women, selected using a systematic random sampling method. A pretested self-administered questionnaire was used to collect data which contains four parts. Below variables were involved and both continuous and categorical data were collected as required. 'Maternal sleep quality, socio-demographic data and gestational age, maternal depression and anxiety.' Data were analyzed using IBM SPSS version 25.0 for Windows by using descriptive statistics, Pearson's Chi-square test, and independent sample T-test (p < 0.05). Logistic regression analysis was used to find the relationship with sleep quality and other variables. P-value of less than 0.05 was considered statistically significant, at 95% CI. Results: The majority of women (60.8%) had good sleep quality and they didn't have either depressive symptoms (63.4%) or anxiety (64.2%). Aged between 34–41 years and third-trimester women had higher rates of poor sleep quality. Varying quality of sleep was identified among three-trimesters with subjective sleep quality, sleep latency, habitual sleep efficiency, and sleep disturbances. In comparison with the first and second trimester, pregnant women in the third trimester had higher score of global PSQI (5.22 ± 2.35), subjective sleep quality (1.23 ± 0.70), sleep latency (1.25 ± 0.86), habitual sleep efficiency (0.14 ± 0.43), and sleep disturbances (1.39 ± 0.58). There was a significant association between gestational age (P =.006), maternal age (P =.009), antenatal depression (P =.034), and anxiety (P =.013) with sleep quality. However, multinomial logistic regression revealed that only gestational age affected on quality of sleep. The first trimester was a protective factor for good quality sleep (Adjusted OR = 3.156) compared to the other two trimesters. Conclusion: This study revealed that the majority of women had good sleep quality but quality of sleep was deprived with gestational age. It is expected that the findings of this research will be helpful for health and social care policymakers when formulating guidelines and interventions regarding improving the quality of sleep among pregnant women in Sri Lanka. [ABSTRACT FROM AUTHOR]

Background. Mothers with a history of gestational diabetes mellitus (GDM) have a high risk of progressing to type 2 diabetes mellitus (T2DM) in the future. This progression can be attenuated by appropriate lifestyle interventions. We aimed to understand the perceptions of mothers with GDM and their healthcare workers regarding postpartum physical activity with a view to design a lifestyle intervention programme. Methods. We did this qualitative study in three selected districts of Sri Lanka. We also conducted six focus group discussions with 30 antenatal mothers with a history of GDM in a previous pregnancy, and six in-depth interviews with 3 postnatal nurses and 3 field midwives caring for postpartum mothers to explore their perceptions on postpartum physical exercises. Framework analysis was used to analyse the data. The transcripts were analysed using a Microsoft matrix and themes were generated. Results. Eight themes related to physical exercises emerged from both groups of participants. Two themes, 'Myths regarding postpartum physical activity' and 'Lack of awareness of the importance of postpartum physical activity' emerged from both groups of participants. Three themes, 'Time pressure', 'Stigma' and 'Child demands' emerged only from mothers while three themes, 'Traditional and cultural beliefs', 'Lack of influence from healthcare workers' and 'Lack of motivation' emerged solely from healthcare workers. Conclusions. The findings, especially the facilitators and barriers deserve the attention of health policy-makers when designing appropriate interventions to enhance postpartum physical exercises to attenuate the development of T2DM in women with GDM. [ABSTRACT FROM AUTHOR]

Objectives: Gestational diabetes mellitus (GDM) is a world health concern. Women with a history of GDM have a high prevalence of developing type two diabetes mellitus, recurrence of GDM, and impaired glucose intolerance in their future life. Physical activity (PA) is a key component to attenuate the development of these complications. Therefore, the aim of this study was to evaluate the PA patterns of GDM women at 6 weeks postpartum. Material and Methods: This descriptive cross-sectional component of a large quasi-experimental study was conducted in three selected districts of Sri Lanka in 100 postpartum mothers. Anthropometric and glycemic parameters were assessed at 6 weeks postpartum. Pre-tested International PA Questionnaire (short-version) was used to assess PA. The PA level and intensity were calculated in metabolic equivalent task minutes per week (METminutes/week). Data were analyzed by SPSS 21 version. Both continuous and categorical data were analyzed. Ethical clearance was obtained from the University of Sri Jayewardenepura. Results: Mean HbA1c value was 6.64 ± 1.95. Median truncated PA was 3250 MET-minutes/week. The main contributors to energy expenditure in the study sample were moderate intensity household activities and walking with 58% of mothers walking more than 150 min/week. Although in the categorical analysis, 52% of mothers reported high level of PA, only 10% participated in at least one vigorous intensity activity continuously for more than 10 min to achieve reduced metabolic risks. Average sitting time of mothers was about 3 h/day which is in par with the breast-feeding recommendation. None of the PA MET values significantly correlated with the glycemic parameter, HbA1c. Conclusion: Although it appears that majority of mothers are physically active, these activities are not optimum in terms of reducing the metabolic risk. We suggest designing exercise protocols incorporating day-to-day moderate intensity activities and walking in a structured and scientific manner to achieve maximum benefits for this special group of women. [ABSTRACT FROM AUTHOR]