Evaluation for sleep quality and depression should be part of routine prenatal check-ups. Information on women's sleep quality, stress, and depressive status can be used to individualize interventions for pregnancy-associated sleep disorder.

These findings offer evidence that healthcare professionals should provide sleep counseling to pregnant women, and incorporate depression and body image into a supportive model of sleep-related prenatal care.

This study identified poor sleep quality during the third trimester as a novel risk factor for vacuum-assisted delivery. We suggest that prenatal healthcare providers focus greater attention to the sleep disturbance condition of pregnant women and provide proactive sleep counseling to facilitate pregnant women's adjustment to the new psychosocial and physiological demands of motherhood.