Poster #46 - Indirect Associations Between Prenatal Maternal Depressive and Anxious Symptoms and Infant Sleep at 6 Months

• In Event: Poster Session 13

Abstract

Depression comorbid with anxiety is common in women in their childbearing years and has been correlated with poor sleep in their offspring (Toffol et al., 2018). However, less is known about the longitudinal impact of mothers’ prenatal depression and anxiety on infants’ sleep. Emerging evidence suggests that high levels of prenatal stress in mothers can alter the fetus’s hypothalamic-pituitary-adrenal axis and the autonomic nervous system, leading to disruptions in infant sleep quantity and quality (O’Connor et al., 2007). On the other hand, the effect of maternal prenatal depression and anxiety on infant sleep may also be indirect, through the impact on mothers’ sleep, as the link between mood disturbances and sleep in mothers is well-established (Okun, 2015). Thus, the present study examined the direct and indirect associations between maternal prenatal depressive and anxiety symptoms and infant sleep at 6 months postpartum, examining maternal sleep at 1 month as a potential mediator.

Data were drawn from an ongoing randomized control trial on sleep and family relationships in the transition to parenthood. Participants included 209 mothers and their first-born infants. In the mothers’ third trimester of pregnancy, depressive symptoms were measured using the Beck Depression Inventory (BDI; Beck et al., 1961) and anxiety symptoms were assessed using the Beck Anxiety Inventory (BAI; Beck et al., 1988). The current study assessed mothers’ sleep at 1 month and infant sleep at 6 months using the Philips Respironics AW-64 actiwatch, worn continuously across eight days and nights. Mean and variability of sleep onset time and total sleep minutes were calculated using the Philips Respironics software.

Path analyses were conducted using the lavaan package (Rosseel, 2012) in R program to test the hypothesized direct and indirect relations. Indirect effects were tested using bias corrected bootstrapped confidence intervals based on 5000 samples. Higher prenatal depressive symptoms in mothers were not directly linked, but were indirectly linked, to later sleep onset time (95% CI [.006, .032]), more variability in sleep onset time (95% CI [.002, .022]), and less total sleep time in infants aged 6 months (95% CI [-.015, -.001]) through mothers’ same sleep components at 1 month (Figure 1). Similarly, no direct links were found between mothers’ prenatal anxious symptoms and infant sleep at 6 months, but higher prenatal anxious symptoms were indirectly linked to later sleep onset time (95% CI [.002, .024]) and higher variability in sleep onset time in 6-month-old infants (95% CI [.002, .022]), through mothers’ same sleep components at 1 month (Figure 2).

Findings suggest that both prenatal depressive and anxious symptoms in mothers are indirectly associated with poorer infant sleep at 6 months of age, through its associations with mothers’ problematic sleep at 1 month postpartum. The results highlight that sleep problems in infancy may be related to maternal mental health during pregnancy, and thus interventions targeting symptoms of depression and anxiety in mothers prenatally may be impactful in preventing future sleep problems in infants.

Authors

• Karen Guo

• Christine Kim, Pennsylvania State University, University Park
  Presenting Author

• Brian Crosby, Pennsylvania State University

• Douglas M Teti, The Pennsylvania State University