Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland.
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland; University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research, Edinburgh, UK.
Sleep Med. 2019 Apr;56:201-210. doi: 10.1016/j.sleep.2018.10.042. Epub 2018 Dec 14.
Maternal depressive symptoms during pregnancy have been associated with poor offspring sleep. Yet, it remains unknown whether depressive symptoms throughout pregnancy are more harmful to the child than depressive symptoms only during certain time periods in pregnancy, whether associations are specific to pregnancy stage, whether maternal symptomatology after pregnancy mediates or adds to the prenatal effects, and whether any effects are specific to some child sleep characteristics.
A total of 2321 mothers from the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) study completed the Center for Epidemiological Studies Depression Scale biweekly between gestational weeks + days 12 + 0/13 + 6 and 38 + 0/39 + 6. At child's mean age of 3.5 (standard deviation = 0.7) years, mothers completed the Beck Depression Inventory-II and answered questions on child sleep quantity and quality using the Brief Infant Sleep Questionnaire (BISQ) and sleep disorders using the Sleep Disturbance Scale for Children.
Maternal depressive symptoms showed high stability throughout pregnancy. Children of mothers with clinically significant symptomatology throughout pregnancy had shorter mother-rated sleep duration, longer sleep latency, higher odds for waking up two or more times during the night and for total and several specific sleep disorders. These associations were robust to covariates. However, maternal depressive symptoms at the child follow-up fully mediated the associations with sleep duration and awakenings, partially mediated those with sleep latency and disorders, and added to the effects on sleep disorders.
Maternal depressive symptoms throughout pregnancy are associated with mother-rated child sleep quantity, quality, and disorders. Maternal depressive symptoms at child follow-up mediate and add to the prenatal adverse effects on child sleep characteristics.
孕期母体抑郁症状与后代睡眠质量差有关。然而,目前尚不清楚整个孕期的抑郁症状是否比孕期特定时间段的抑郁症状对儿童更有害,关联是否具有特定的孕期阶段特征,产后母亲的症状是否会调节或增加产前影响,以及任何影响是否具有特定的儿童睡眠特征。
共有 2321 名来自预测和预防子痫前期和宫内生长受限(PREDO)研究的母亲在妊娠第 12 天+0/13 天+6 至第 38 天+0/39 天+6 期间的每周 2 次完成了流行病学研究抑郁量表。在孩子的平均年龄为 3.5 岁(标准差=0.7)时,母亲完成了贝克抑郁量表第二版,并使用简要婴儿睡眠问卷(BISQ)回答了关于儿童睡眠量和质的问题,以及使用儿童睡眠障碍量表回答了睡眠障碍问题。
母亲的抑郁症状在整个孕期表现出很高的稳定性。整个孕期出现临床显著症状的母亲的孩子的母亲评分睡眠时间较短,睡眠潜伏期较长,夜间醒来两次或更多次以及总睡眠和几种特定睡眠障碍的几率较高。这些关联在控制了协变量后仍然很稳健。然而,儿童随访时母亲的抑郁症状完全调节了与睡眠时间和觉醒的关联,部分调节了与睡眠潜伏期和障碍的关联,并增加了对睡眠障碍的影响。
整个孕期母亲的抑郁症状与母亲评估的儿童睡眠量、质和障碍有关。儿童随访时母亲的抑郁症状既可以作为产前对儿童睡眠特征产生不良影响的中介因素,也可以增加其影响。