Mete Yesil Ayse, Şencan Karakuş Buse, Kılınç Şeyma, Yaman Artunç Nihal, Özmert Elif Nursel
Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Türkiye.
Division of Developmental Pediatrics, Department of Pediatrics, Ankara Bilkent City Hospital, Ankara, Türkiye.
BMJ Paediatr Open. 2025 May 26;9(1):e003167. doi: 10.1136/bmjpo-2024-003167.
Late preterm infants (LPT) are often overlooked despite representing a significant proportion of preterm births. This study explores the sleep characteristics of LPT infants aged 3-6 months compared with their term-born peers and investigates the relationship between infant sleep patterns, maternal mental health and maternal knowledge about infant sleep.
A total of 84 infant-mother dyads were included. Infant sleep characteristics were assessed using the Brief Infant Sleep Questionnaire (BISQ) with an additional norm-referenced scoring system to evaluate age-based sleep parameters. Maternal mental health was evaluated through the Depression, Anxiety and Stress Scale (DASS-21) and maternal knowledge of infant sleep was measured using a questionnaire based on the American Academy of Pediatrics' recommendations.
Sleep patterns between LPT and term infants were comparable, including nocturnal sleep duration (p=0.75) and nocturnal awakenings (p=0.33). However, maternal perceptions of sleep quality significantly differed, with LPT infants scoring higher on the Parent Perception subscale of the BISQ (median: 82.5 vs 70, p=0.04). Maternal DASS scores were negatively correlated with BISQ subscales in LPT infants. Anxiety scores were significantly associated with Parent Perception (r=-0.413, p<0.01) and total BISQ scores (r=-0.418, p<0.01). Depression was linked to lower Parent Perception (r=-0.346, p=0.03) and total BISQ scores (r=-0.319, p=0.04), while stress was associated with lower Parent Perception scores (p=0.03). In term infants, maternal knowledge of infant sleep was significantly higher in good sleepers (p=0.03), while maternal DASS scores showed no significant associations with sleep outcomes.
Infant sleep should be considered within the maternal-infant dyad, with maternal factors playing a crucial role in shaping sleep outcomes, differing between LPT and term infants. The interplay between maternal mental health, parental sleep knowledge and sleep expectations warrants further investigation.
晚期早产儿（LPT）在早产中占很大比例，但往往被忽视。本研究探讨了3至6个月大的晚期早产儿与其足月儿同龄人的睡眠特征，并调查了婴儿睡眠模式、母亲心理健康和母亲对婴儿睡眠的知识之间的关系。
共纳入84对母婴。使用简短婴儿睡眠问卷（BISQ）评估婴儿睡眠特征，并使用额外的常模参照评分系统来评估基于年龄的睡眠参数。通过抑郁、焦虑和压力量表（DASS-21）评估母亲的心理健康，并使用基于美国儿科学会建议的问卷来测量母亲对婴儿睡眠的知识。
晚期早产儿和足月儿的睡眠模式具有可比性，包括夜间睡眠时间（p=0.75）和夜间觉醒次数（p=0.33）。然而，母亲对睡眠质量的认知存在显著差异，晚期早产儿在BISQ的父母认知子量表上得分更高（中位数：82.5对70，p=0.04）。母亲的DASS得分与晚期早产儿的BISQ子量表呈负相关。焦虑得分与父母认知显著相关（r=-0.413，p<0.01）和BISQ总分（r=-0.418，p<0.01）。抑郁与较低的父母认知（r=-0.346，p=0.03）和BISQ总分（r=-0.319，p=0.04）相关，而压力与较低的父母认知得分相关（p=0.03）。在足月儿中，睡眠良好的母亲对婴儿睡眠的知识显著更高（p=0.03），而母亲的DASS得分与睡眠结果无显著关联。
应在母婴二元组中考虑婴儿睡眠，母亲因素在塑造睡眠结果中起关键作用，晚期早产儿和足月儿有所不同。母亲心理健康、父母睡眠知识和睡眠期望之间的相互作用值得进一步研究。
