Sleep During Early Infancy: The Role of Maternal Prenatal Anxiety

• In Event: The Importance of Sleep Across the Perinatal Period: Implications for Maternal and Infant Well-being

Abstract

Background. During infancy, healthy sleep behaviors are critical for overall functioning and development, including brain development and physiological functioning (Bernier et al., 2010). However, infant sleep difficulties are commonly reported as concerns by caregivers to pediatricians (Field, 2017) and if not addressed, are associated with negative consequences for infants’ long-term physical, cognitive, and social-emotional development (Field, 2017). One factor that is commonly examined in relation to infant developmental outcomes is maternal mental health (Roubinov et al., 2021), and notably, postnatal anxiety has been associated with infant sleep problems, including increased night awakenings and fragmented sleep (Ma et al., 2022). However, although there is evidence that fetal exposure to psychopathology may be harmful for infant regulatory functioning (Glover et al., 2018), there is currently a lack of research that examines the relationship between prenatal anxiety and infant sleep difficulties. The current study addresses this gap by examining direct and indirect associations of maternal prenatal anxiety symptoms on infant sleep problems from 6 to 16 weeks postpartum.

Methods. Participants include 35 mothers (41.2% White) and their infants recruited during pregnancy at 30 weeks gestation from community prenatal clinics. Mothers completed the Perinatal Anxiety Screening Scale during pregnancy to assess anxiety symptoms (PASS; Somerville et al., 2014) and reported on infant sleep behaviors at 6- and 16-weeks postpartum (Infant Sleep Questionnaire; Morrell, 1999). The excessive worry subscale from the PASS was used in analyses.

Results. Path analysis using Mplus 8.0 was used to examine the mediating role of infant sleep problems at 6 weeks postpartum on the relationship between maternal prenatal worry and infant sleep problems at 16 weeks postpartum, with mother education level and infant sex included as covariates. Results showed that excessive prenatal worry was associated with greater infant sleep problems at 6 weeks postpartum (b=.75, SE=.37, p=.003). Further, infant sleep problems at 6 weeks postpartum were positively associated with infant sleep problems at 16 weeks postpartum (b=.53, SE=.18, p=.042). Maternal prenatal worry was not directly related to infant sleep problems at 16 weeks, but rather indirectly related through 6-week infant sleep problems, ab = .397, 95%CI [.008, 1.004].

Discussion. Findings highlight maternal prenatal anxiety, and specifically excessive worry, as a salient risk factor for persistent infant sleep difficulties that may be a target for prenatal interventions to support later infant sleep regulation. Findings will be discussed in relation to fetal programming (Glover et al., 2018) and will also consider the role of postpartum maternal mental health symptoms.

Authors

• Ashley N Quigley, Oklahoma State University - Stillwater
  Presenting Author

• Gina Erato, Oklahoma State University - Stillwater

• Kristin Fields, Oklahoma State University - Stillwater

• Elizabeth Hinckley, Oklahoma State University - Stillwater

• Samantha Addante, Oklahoma State University - Stillwater

• Lucia Ciciolla, Oklahoma State University - Stillwater