{
  "abstract": "Background\n\nPrenatal depression and anxiety have emerged as pressing global public health challenges. In the digital era, excessive smartphone use may exert complex effects on maternal mental health. Prior research has predominantly focused on adolescents, whereas evidence among pregnant women, particularly regarding total weekly use and use during critical circadian windows, such as after waking and before bedtime, remains limited. Furthermore, the mediating role of sleep quality in these associations has yet to be systematically examined.Objective\n\nThis study aimed to investigate the associations of smartphone addiction and time-specific smartphone use with prenatal depression and anxiety, and to assess the mediating role of sleep quality in these associations.Methods\n\nThis cross-sectional observational study enrolled 537 pregnant women. Smartphone use characteristics, sleep quality, and prenatal depression and anxiety were assessed using the Smartphone Addiction Scale-Short Version (SAS-SV), objective total weekly smartphone use recorded by the device, and self-reported duration of smartphone use after waking and duration of bedtime smartphone use; the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Binary logistic regression was used to estimate associations, restricted cubic spline (RCS) models were used to explore nonlinear patterns, and exploratory mediation analyses were used to examine whether sleep quality statistically accounted for part of the observed associations.Results\n\nThe prevalence of moderate-to-severe prenatal depression and anxiety was 8.8% (47/537) and 5.8% (31/537), respectively. After adjusting for covariates, smartphone addiction was associated with higher odds of depression (odds ratio [OR] 3.461, 95% CI 1.771-7.100) and anxiety (OR 7.738, 95% CI 3.064-23.172). Duration of smartphone use after waking ≥61 minutes and duration of bedtime smartphone use ≥91 minutes were also associated with higher odds of affective disorders. RCS analyses further revealed distinct nonlinear patterns across different exposure dimensions: duration of smartphone use after waking displayed U-shaped and J-shaped associations with depression and anxiety, respectively, while total weekly use displayed a U-shaped association with anxiety. Exploratory mediation analyses showed that the indirect pathways through sleep quality were statistically significant for the associations of bedtime smartphone use, weekly smartphone use, and smartphone addiction with prenatal depression, with mediation proportions of 44.89% (0.0065/0.0145), 31.30% (0.0056/0.0183), and 31.48% (0.0415/0.1315), respectively. The corresponding proportions in the anxiety models were 35.83% (0.0044/0.0123), 27.05% (0.0039/0.0144), and 22.73% (0.0271/0.1187).Conclusions\n\nSmartphone addiction and excessive smartphone use after waking and before bedtime were associated with higher odds of prenatal depression and anxiety. Sleep quality may statistically account for part of these associations, but longitudinal studies are needed to establish temporal ordering and causal pathways.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Changsha, Hunan, 410013, China, 86 1-597-147-1776.",
    "Hunan Provincial Maternal and Child Health Hospital, Changsha, Hunan, China.",
    "Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Xiangxin Zhang",
      "orcid": "0009-0005-2223-9236"
    },
    {
      "affs": [
        1
      ],
      "name": "Mixia Ouyang",
      "orcid": "0009-0009-1968-1348"
    },
    {
      "affs": [
        1
      ],
      "name": "Xiaoli Wu",
      "orcid": "0009-0007-4643-7960"
    },
    {
      "affs": [
        0
      ],
      "name": "Xinghua Yang",
      "orcid": "0009-0009-3665-3402"
    },
    {
      "affs": [
        0
      ],
      "name": "Xinyi Wang",
      "orcid": "0009-0001-2650-4632"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuxinqiao Cao",
      "orcid": "0009-0004-8618-3836"
    },
    {
      "affs": [
        1
      ],
      "name": "Mingmin Xu",
      "orcid": "0009-0000-0718-9385"
    },
    {
      "affs": [
        2
      ],
      "name": "Yanling Shu",
      "orcid": "0009-0005-5684-4776"
    },
    {
      "affs": [
        0
      ],
      "name": "Mingyang Wu",
      "orcid": "0000-0003-3001-1897"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c1k3m3rjjgmcf.bib",
  "cited_by": 0,
  "doi": "10.2196/100064",
  "fulltext_url": "https://europepmc.org/articles/PMC13721738",
  "id": "c1k3m3rjjgmcf",
  "issns": [
    "2291-5222"
  ],
  "landing_url": "https://europepmc.org/article/MED/42961314",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Anxiety and Stress Disorders"
    ],
    [
      "heading",
      "Depression and Mood Disorders; Suicide Prevention"
    ],
    [
      "heading",
      "Mobile Health (mhealth)"
    ],
    [
      "heading",
      "Original Paper"
    ],
    [
      "heading",
      "Sleep Monitoring, Sleep Quality, Sleep Disorders"
    ],
    [
      "heading",
      "mHealth for Symptom and Disease Monitoring, Chronic Disease Management"
    ],
    [
      "heading",
      "mHealth for Wellness, Behavior Change and Prevention"
    ],
    [
      "lcc",
      "RA1-1270"
    ],
    [
      "lcc",
      "T58.5-58.64"
    ],
    [
      "openalex",
      "2739|Maternal Mental Health During Pregnancy and Postpartum"
    ]
  ],
  "openalex": "W7213472277",
  "pdf_url": "https://europepmc.org/articles/PMC13721738?pdf=render",
  "pmcid": "PMC13721738",
  "pmid": "42961314",
  "published": "2026-10-01",
  "publisher": "JMIR Publications Inc.",
  "ris": "https://research.draconitic.com/paper/c1k3m3rjjgmcf.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:50Z",
      "native_id": "MED:42961314",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42961314"
    },
    {
      "first_seen": "2026-11-03T12:22:23Z",
      "native_id": "PMC13721738",
      "source": "pmc",
      "url": "https://doi.org/10.2196/100064"
    },
    {
      "first_seen": "2026-11-07T14:20:56Z",
      "native_id": "0d9db31ee2564840a31c1938a71ebe82",
      "source": "doaj",
      "url": "https://doi.org/10.2196/100064"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Maternal Mental Health During Pregnancy and Postpartum",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "The Mediating Role of Sleep Quality in Associations of Smartphone Addiction and Time-Specific Use With Prenatal Depression and Anxiety: Cross-Sectional Observational Study.",
  "title_text": "The Mediating Role of Sleep Quality in Associations of Smartphone Addiction and Time-Specific Use With Prenatal Depression and Anxiety: Cross-Sectional Observational Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T14:20:24Z",
  "url": "https://research.draconitic.com/paper/c1k3m3rjjgmcf",
  "venue": "JMIR mHealth and uHealth",
  "versions": []
}