This prospective observational study evaluates whether maternal sleep quality, anxiety levels, and nighttime digital behavior are associated with labor progression among term primiparous women. Sleep quality and anxiety are assessed before the onset of labor during routine antenatal visits using validated instruments, including the Pittsburgh Sleep Quality Index (PSQI) and the Beck Anxiety Inventory (BAI). Nighttime digital behavior characteristics, such as screen exposure and smartphone use prior to sleep, are recorded through standardized antenatal interviews.

Labor outcomes, including the duration of the latent, active, and second stages of labor, requirement for oxytocin augmentation, use of analgesia, and mode of delivery, are prospectively documented from hospital admission until birth. By examining behavioral and psychological factors prior to labor onset, the study aims to determine whether poor sleep quality, increased anxiety, or irregular nighttime digital activity are associated with prolonged labor phases or greater need for obstetric interventions.

This prospective observational cohort study investigates the influence of maternal sleep quality, anxiety levels, and nighttime digital device use on labor progression among term primiparous women. Eligible participants were term primiparous women attending routine antenatal follow-up at Izmir Tepecik Training and Research Hospital. All psychosocial assessments were completed prior to the onset of labor. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), and anxiety levels were assessed using the Beck Anxiety Inventory (BAI). Nighttime digital behavior characteristics were documented through structured antenatal interviews and included pre-sleep screen exposure, smartphone use in bed, frequency of nighttime phone checking, and the type of digital content viewed before sleep.

Participants were subsequently followed through spontaneous labor, and labor-related data were collected prospectively. Initial labor characteristics documented at hospital admission included cervical dilation, contraction pattern, and overall clinical presentation. Additional labor outcomes, including the duration of the latent, active, and second stages of labor, use of oxytocin augmentation, requirement for epidural or opioid analgesia, operative vaginal delivery, cesarean delivery, and neonatal outcomes, were recorded systematically according to standardized institutional protocols.

The primary aim of the study is to determine whether poor sleep quality, elevated anxiety levels, or increased nighttime digital device use are associated with prolonged labor or dysfunctional labor patterns. Secondary aims include examining whether interactions between digital behavior variables and psychological factors contribute to variations in maternal labor physiology or to increased obstetric intervention rates.

Inclusion Criteria:

• Pregnant women at ≥ 37 weeks of gestation
• Completion of PSQI (sleep quality) and BAI (anxiety) assessments during antenatal clinic visit
• Singleton pregnancy
• Cephalic presentation
• Age 18 to 50 years
• Planning to deliver at the study hospital
• Able to provide informed consent

Exclusion Criteria:

• Multiple pregnancy
• Non-cephalic presentation
• Delivery occurring at another hospital or birth center
• Elective planned cesarean delivery
• Major fetal anomaly
• Placenta previa or placenta accreta spectrum
• Preeclampsia, eclampsia, HELLP syndrome
• Gestational diabetes requiring insulin
• Chronic medical disorders affecting labor physiology
• Use of sedative, hypnotic, or psychotropic medications
• Inability to complete questionnaires

Only self-identified women who are biologically female and pregnant are eligible to participate in this study.

This study population consists of term primiparous pregnant women who attended routine antenatal follow-up at Izmir Tepecik Training and Research Hospital and subsequently experienced spontaneous onset of labor. All participants were healthy, low-risk obstetric patients with singleton, cephalic presentations and no medical or obstetric complications.

Individual participant data will not be shared. The dataset contains sensitive clinical information from pregnant women and cannot be made publicly available due to institutional and national data protection regulations. Summary results will be published in peer-reviewed journals, but no individual-level data will be released.