Geiger Sarah Dee, Chandran Aruna, Churchill Marie L, Mansolf Maxwell, Zhang Cai, Musaad Salma, Blackwell Courtney K, Eick Stephanie M, Goin Dana E, Korrick Susan, Alshawabkeh Akram, Brennan Patricia A, Breton Carrie V, Cordero Jose F, Deoni Sean, D'Sa Viren, Dunlop Anne L, Elliott Amy J, Ferrara Assiamira, Keddie Arlene, LeBourgeois Monique, LeWinn Kaja Z, Koinis-Mitchell Daphne, Lucchini Maristella, Nozadi Sara S, O'Connor Thomas, Zhu Yeyi, Zimmerman Emily, Schantz Susan L
Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
Pediatr Res. 2025 Feb;97(3):980-988. doi: 10.1038/s41390-024-03542-4. Epub 2024 Oct 11.
Childhood sleep quality is associated with physical, cognitive, and behavioral health and predicts later sleep quality; it has many determinants, including developmental exposures.
To examine associations between maternal stress during pregnancy and childhood sleep quality and determine whether postnatal stress mediates the association.
Data from the Environmental Influences on Child Health Outcomes cohort were used. Perceived Stress Scale (PSS) T-scores were the exposure measure. Outcome measures were preschool Child Behavior Checklist (CBCL) sleep syndrome scale and Patient-Reported Outcomes Measurement Information System Sleep Disturbance Parent Proxy short form 4a (PSD4a) T-scores at ages 4-8 years. Linear mixed-effects regression modeling was performed for each sleep outcome, adjusting for maternal age at delivery and education and child sex, gestational age at birth, and age at outcome ascertainment, with random intercepts for cohorts.
Prenatal PSS score was associated with both CBCL (B = 0.09, 95% confidence interval [CI]: 0.06, 0.11; p < 0.01) and PSD4a (B = 0.07, 95% CI: 0.03, 0.12; p < 0.01) scores. Postnatal perceived stress mediated a proportion of the total effect of prenatal stress in both CBCL (66.3%) and PSD4a (95.9%) samples.
Both pre- and postnatal maternal perceived stress appear to influence sleep quality during early life.
Prenatal stress significantly associates with child sleep problems and disturbances at ages 4-8 years; postnatal maternal stress is a significant mediator of these associations. Research suggests a range of prenatal affective/distress exposures associated with child sleep problems, but the conclusions remain in doubt due to the mixture of exposures and outcomes employed. Ours is the first US-based effort to explore associations between perceived maternal stress during pregnancy and child sleep problems and disturbance in early and middle childhood. Even a small effect of a prevalent issue like psychosocial stress may have important public health implications at the population level.
儿童睡眠质量与身体、认知和行为健康相关，并可预测日后的睡眠质量；其有许多决定因素，包括发育暴露。
研究孕期母亲压力与儿童睡眠质量之间的关联，并确定产后压力是否介导这种关联。
使用来自儿童健康结果环境影响队列的数据。感知压力量表（PSS）T分数作为暴露指标。结果指标为4至8岁时的学龄前儿童行为检查表（CBCL）睡眠综合征量表以及患者报告结局测量信息系统睡眠障碍家长代理简表4a（PSD4a）T分数。对每个睡眠结果进行线性混合效应回归建模，调整分娩时母亲年龄、教育程度、孩子性别、出生孕周以及确定结果时的年龄，并对队列进行随机截距分析。
产前PSS分数与CBCL（B = 0.09，95%置信区间[CI]：0.06，0.11；p < 0.01）和PSD4a（B = 0.07，95% CI：0.03，0.12；p < 0.01）分数均相关。产后感知压力在CBCL（66.3%）和PSD4a（95.9%）样本中介导了产前压力总效应的一部分。
产前和产后母亲的感知压力似乎都会影响儿童早期的睡眠质量。
产前压力与4至8岁儿童的睡眠问题和障碍显著相关；产后母亲压力是这些关联的重要介导因素。研究表明一系列产前情感/痛苦暴露与儿童睡眠问题有关，但由于所采用的暴露和结果的混合情况使得结论仍存疑问。我们是美国首个探索孕期母亲感知压力与儿童睡眠问题以及儿童早期和中期睡眠障碍之间关联的研究。即使像心理社会压力这样普遍问题的微小影响在人群层面也可能具有重要的公共卫生意义。
