Okun Michele L, Payne Jennifer L, Osborne Lauren M, Feliciano Leilani, Lac Andrew
University of Colorado Colorado Springs, Colorado Springs, CO, United States.
University of Virginia, Charlottesville, VA, United States.
JMIR Res Protoc. 2025 Apr 10;14:e66439. doi: 10.2196/66439.
Postpartum mood and anxiety disorders (PMADs) are higher among pregnant military service women (26%) and military spouses (12.2%) compared to the civilian population (10%-15%). This is partly due to military-specific factors, including deployment, which are known to increase risk. Important risk factors for PMADs include sleep disturbances, defined as sleep deprivation, insomnia, or poor sleep quality, which are more are common among military-affiliated pregnant women.
This study describes a protocol for a new randomized controlled trial that aims to ameliorate the risk for PMADs through improving infant sleep or maternal sleep during the first 6 postdelivery months in a sample of military-affiliated women.
This study is a 6-month, parallel-arm, randomized controlled trial. Pregnant women (N=342) in the third trimester will be randomized at 1:1 ratio to use a smart bassinet (SB) or a standard commercially available bassinet (HALO BassiNest Swivel Sleeper 3.0; traditional bassinet [TB]) for up to 6 months after delivery. Participants will have their infants sleep in the bassinet, complete monthly web-based questionnaires, and record sleep data with diary and actigraphy for both the participants and their infants for 1 week each postpartum month. Blood samples will also be collected at baseline (late pregnancy) and at 3 months and 6 months post partum to assess immune functioning. The primary outcomes for this study will be postpartum mood (depressive and anxiety symptoms) and infant and maternal sleep. In addition, we are evaluating whether SB has a significant impact on immune functioning-a marker that physiologically connects sleep and mood symptoms.
Recruitment for this study began in January 2025. Six separate mixed 2 (treatment vs control) × 6 (assessment period) multivariate analysis of variance and analysis of variance models will be conducted to test the hypotheses that SB will have a greater impact on infant and maternal sleep than TB, SB will be associated with a greater reduction in postpartum mood symptoms than TB, and immune system function will be less dysregulated in birthing individuals using SB compared to those using TB. Lastly, we will evaluate whether the elevated risk demonstrated by previously identified postpartum depression epigenetic biomarkers in the TTC9B and HP1BP3 genes can be modified with an SB. We hypothesize that the elevated risk will be reduced in SB compared to that in TB.
At the conclusion of this project, we will have gained a thorough understanding of the capability of SB to positively affect infant and maternal sleep compared to the traditional sleep arrangement and its impact on maternal mood through 6 months post partum in military-affiliated women. The promotion of sleep health in both mothers and infants may be an accessible and amenable method to prevent PMADs.
ClinicalTrials.gov NCT06544941; https://clinicaltrials.gov/study/NCT06544941.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/66439.
与普通人群(10%-15%)相比,怀孕的现役军人(26%)和军属(12.2%)中产后情绪和焦虑障碍(PMADs)的发生率更高。部分原因是包括部署在内的军事特有因素,已知这些因素会增加患病风险。PMADs的重要风险因素包括睡眠障碍,定义为睡眠剥夺、失眠或睡眠质量差,在与军事有关联的孕妇中更为常见。
本研究描述了一项新的随机对照试验方案,旨在通过改善与军事有关联的女性产后前6个月的婴儿睡眠或母亲睡眠,来降低患PMADs的风险。
本研究是一项为期6个月的平行组随机对照试验。孕晚期的孕妇(N=342)将按1:1的比例随机分组,产后最多6个月使用智能婴儿床(SB)或标准市售婴儿床(HALO BassiNest Swivel Sleeper 3.0;传统婴儿床[TB])。参与者将让婴儿睡在婴儿床里,每月完成基于网络的问卷,并在产后每个月用日记和活动记录仪记录参与者及其婴儿1周的睡眠数据。还将在基线(孕晚期)、产后3个月和6个月采集血样,以评估免疫功能。本研究的主要结局将是产后情绪(抑郁和焦虑症状)以及婴儿和母亲的睡眠。此外,我们正在评估SB是否对免疫功能有显著影响——免疫功能是一个在生理上将睡眠和情绪症状联系起来的指标。
本研究于2025年1月开始招募。将进行6项独立的混合2(治疗组与对照组)×6(评估期)多变量方差分析和方差分析模型,以检验以下假设:与TB相比,SB对婴儿和母亲睡眠的影响更大;与TB相比,SB与产后情绪症状的更大程度减轻相关;与使用TB的分娩个体相比,使用SB的个体免疫系统功能失调程度更低。最后,我们将评估TTC9B和HP1BP3基因中先前确定的产后抑郁表观遗传生物标志物所显示的升高风险是否可以通过SB来改变。我们假设与TB相比,SB的升高风险会降低。
在本项目结束时,我们将全面了解与传统睡眠安排相比,SB对婴儿和母亲睡眠产生积极影响的能力及其对产后6个月军属母亲情绪的影响。促进母婴睡眠健康可能是预防PMADs的一种可行且适用的方法。
ClinicalTrials.gov NCT06544941;https://clinicaltrials.gov/study/NCT06544941。
国际注册报告识别码(IRRID):PRR1-10.2196/66439。