Maternal depressive emotion associated with children's sleep problems

"The most surprising thing about our results was the mediation role of child behavior in the maternal emotion-children's sleep quality relationship, this demonstrates that emotion during pregnancy affects child behavior which further affects child's sleep, said principal investigator and lead author Jianghong Liu, PhD, RN, FAAN, an associate professor at the Schools of Nursing and Medicine at the University of Pennsylvania. "Furthermore, we found that happiness increased across the trimesters and that happiness during the second and third trimester was protective against child sleep problems."

Participants included 833 kindergarteners with mean age of about six years old. Women's emotional status, including prenatal/postnatal depressive emotion and perceived happiness throughout trimesters, was rated by a self-designed set of questions with a 5-point scale for happiness and a 3-point scale for depression. Sleep problems were assessed using the sleep subdomain of the Child Behavior Checklist (CBCL). Child behavioral problems were measured using the CBCL total score. General linear models were performed to examine the adjusted associations between childhood sleep problems and maternal emotional status.

Adjusted models showed that children of women who expressed either depressive emotion during the postnatal period (?=3.13, p=0.003) or during both the prenatal and postnatal periods (?=2.65, p=0.04) were more likely to exhibit sleep disturbances. Similarly, increased levels of happiness in the second and third trimester were significantly associated with decreased risk for children's sleep problems. Results show a significant mediation effect of child's behavior on the maternal emotion and child sleep relationship.

According to Liu and her co-authors (Xiaopeng Ji, Guanghai Wang, Yuli Li and Jennifer Pinto-Martin), these results are noteworthy because they highlight the importance of prenatal maternal emotional health and its impact on child sleep outcomes.

"These results promote the caretaking of maternal health and happiness during pregnancy and encourage the roles of familial and community support in aiding expecting mothers. This will benefit not only maternal health but also the long term behavioral and sleep health of their child," said Liu.

The research abstract was published recently in an online supplement of the journal Sleep and will be presented Tuesday, June 5, in Baltimore at SLEEP 2018, the 32nd annual meeting of the Associated Professional Sleep Societies LLC (APSS), which is a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.