Effect of Mindfulness-Based Stress Reduction Combined With Family Support on Depressive Symptoms and Sleep Quality in Patients With Postpartum Depression: A Retrospective Cohort Study Based on Propensity Score Matching

Abstract

Background: To explore the association between mindfulness-based stress reduction nursing combined with family support nursing and depressive symptoms, sleep quality, related physiological indicators in patients with postpartum depression using a retrospective propensity score-matched design.

Methods: A total of 472 patients with postpartum depression admitted to Nanjing Medical University Affiliated Women’s and Children’s Hospital between October 2022 and October 2025 were included. After propensity score matching, 106 patients who received family support nursing alone (control group) and 106 who received mindfulnessbased stress reduction nursing combined with family support nursing (observation group) were analysed. Outcomes were assessed before nursing, at 4 and 8 weeks after nursing. Repeated measures analysis of variance (ANOVA) and post-hoc tests with Bonferroni correction were applied. The primary outcome was the Edinburgh Postnatal Depression Scale (EPDS) score. Secondary outcomes included Pittsburgh Sleep Quality Index (PSQI) scores, sleep architecture parameters, inflammatory markers (IL-1β, TNF-α, IL-6), salivary cortisol, heart rate variability (HRV) parameters, and nursing satisfaction rate. 

Results: Repeated measures ANOVA revealed significant time, group, and time × group interaction effects for EPDS scores, PSQI scores, and sleep architecture (p < 0.001). At 4 and 8 weeks, EPDS and PSQI scores were lower than baseline values in both group (p < 0.0167, Bonferroni corrected), and scores at week 8 were further reduced compared with those at week 4 (p < 0.0167). The observation group showed significantly lower EPDS and PSQI scores than the control group (p < 0.0167). Similar patterns were observed for inflammatory markers, salivary cortisol, and HRV parameters. The observation group also had a higher satisfaction rate (86.79% vs. 73.58%, p = 0.016).

Conclusions: In this retrospective matched cohort, mindfulness-based stress reduction nursing combined with family support nursing was associated with greater improvements in depressive symptoms, sleep quality, and stress-related physiological parameters compared with family support nursing alone. These associations warrant confirmation in prospective randomised controlled trials.