<p>Participant characteristics (n = 145).</p>

Background Poor sleep quality during pregnancy has been increasingly associated with adverse neonatal outcomes and heightened maternal psychological distress. However, evidence from Middle Eastern populations remains limited, particularly in Saudi Arabia where cultural and environmental factors may influence sleep during pregnancy. Aim To examine the association between maternal sleep quality during pregnancy and adverse neonatal outcomes (ANO), including preterm birth, low Apgar scores, and neonatal intensive care unit (NICU) admission, among postpartum women in Riyadh, Saudi Arabia. Methods This cross-sectional study recruited 223 postpartum women via online platforms; 145 met inclusion criteria and were included in the final analysis. Sleep quality was assessed using a culturally adapted 10-item Arabic Maternal Sleep Quality (MSQ) scale, a culturally adapted 10-item Arabic Maternal Sleep Quality (MSQ) scale that underwent expert review and demonstrated strong internal consistency (Cronbach’s α = 0.88). Maternal psychological well-being and neonatal outcomes were self-reported. Multivariate logistic regression was conducted to identify predictors of ANO, adjusting for confounders. Results Approximately 38.1% of women reported poor sleep quality, and 18.0% experienced at least one adverse neonatal outcome. Poor maternal sleep quality was associated with higher odds of ANO (adjusted OR = 1.75, 95% CI: 1.18–2.59, p = 0.005). A strong positive correlation was found between poor sleep and postpartum psychological distress (r = 0.52, p < .001). Conclusions Poor maternal sleep quality is significantly associated with adverse neonatal outcomes and increased maternal psychological burden. These findings support consideration of routine sleep screening and culturally sensitive sleep-health counseling within antenatal nursing care in Saudi Arabia.研究背景 妊娠期间睡眠质量不佳与不良新生儿结局及孕产妇心理困扰加剧的相关性日益受到重视，但目前中东人群的相关研究证据仍较为有限，在沙特阿拉伯尤为显著——该国的文化与环境因素或会对妊娠期睡眠产生影响。 研究目的 本研究旨在探讨沙特阿拉伯利雅得地区产后女性妊娠期睡眠质量与不良新生儿结局 (Adverse Neonatal Outcomes, ANO) 的关联，不良新生儿结局涵盖早产、低阿普加评分 (Apgar Scores) 及新生儿重症监护病房 (Neonatal Intensive Care Unit, NICU) 收治。 研究方法 本项横断面研究通过线上平台招募223名产后女性，最终145名符合纳入标准的受试者纳入最终分析。睡眠质量评估采用经过文化调适的10条目阿拉伯语版孕产妇睡眠质量量表 (Maternal Sleep Quality Scale, MSQ)，该量表经专家评审，内部一致性良好（克朗巴哈α系数=0.88）。孕产妇心理健康状况与新生儿结局均通过自我报告收集。本研究采用多因素logistic回归分析，在控制混杂因素的前提下识别不良新生儿结局的预测因子。 研究结果 本研究中约38.1%的受试者报告睡眠质量不佳，18.0%的女性至少出现1种不良新生儿结局。孕产妇睡眠质量不佳与不良新生儿结局发生风险升高显著相关（校正后优势比=1.75，95%置信区间：1.18~2.59，p=0.005）。睡眠质量不佳与产后心理困扰呈强正相关（r=0.52，p<0.001）。 研究结论 孕产妇睡眠质量不佳与不良新生儿结局及孕产妇心理负担加重均存在显著关联。本研究结果提示，沙特阿拉伯的产前护理工作中应考虑纳入常规睡眠筛查及契合本土文化的睡眠健康宣教。