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The COVID-19 pandemic has caused elevated distress in pregnant individuals, which has the potential to impact the developing infant. In this study, we examined anxiety and depression symptoms during the pandemic in a large sample of pregnant individuals (n=8602). For a sub-sample of participants, their infants underwent magnetic resonance imaging (MRI) at 3-months of age to examine whether this prenatal maternal distress was associated with infant brain changes. We found significantly elevated prenatal maternal distress compared to pre-pandemic rates, with 47% and 33% of participants reporting clinically significant symptoms of anxiety and depression, respectively. Importantly, we identified social support as a protective factor for clinically elevated prenatal maternal distress. We found significant relationships between prenatal maternal distress and infant amygdala-prefrontal microstructural and functional connectivity and demonstrate for the first time that social support moderates this relationship. Our findings suggest a potentially long-lasting impact of the COVID-19 pandemic on children and show that social support acts as a protective factor not just for pregnant individuals, but also for their developing infants. These findings provide timely evidence to inform clinical practice and policy surrounding the care of pregnant individuals and highlight the importance of social support.

Background Social support and connection with other parents are important factors associated with parental mental health and parenting practices. These social connections can be integrated in parental eHealth programs through forums or group therapy sessions, but parental needs and preferences regarding these eHealth features are unknown. Objective This study aims to examine parents’ preferences for connecting with other parents in eHealth programs. Methods In total, 162 parents of 0-5–year-old children in the United States were recruited through Amazon Mechanical Turk (MTurk; mean age 32.7, range 22-61 years; 80.2% White; 59.9% men, 39.5% women, and 0.6% nonbinary; 93.8% biological parents). Participants filled out a one-time survey. Best practice recommendations for using MTurk were employed (through captcha verification and attention checks). Descriptive statistics were run in SPSS (version 27; IBM Corp) on MacOS. Results Parents were asked to rate how likely they would be to use a digital program with weekly opportunities to connect with other parents in the program (1=very unlikely to 5=very likely). Overall, 13.4% of parents indicated that they would be (very) unlikely to use a program with that feature and 59.8% of them indicated that they would be (very) likely to use it, with the remaining 27.8% of them being neutral. On being asked specifically about their preference, 85% of parents indicated that they would prefer connecting with other parents in the program, with 70% of those preferring to connect anonymously. On a forum, 67% of parents indicated that they would be comfortable connecting with all parents (as opposed to mothers or fathers only); regarding videoconferencing, that number was 61%. Conclusions Considering that studies have shown the positive impact of social support for parental mental health and parenting practices, integrating anonymous connection with other parents should be considered in developing parental eHealth programs and would be in line with the preferences of most parents. Conflicts of Interest None declared.

Context: Socioeconomic status (SES) is increasingly understood to be a key contributor to sleep health, but the research in childhood has not been synthesized.Objective: To examine the associations between indicators of child SES and child sleep (≤18 years old), we conducted a systematic review and meta-analyses. Data Sources: CINAHL with Full Text, PsycINFO, and MEDLINE/PubMed were searched using terms to define SES and childhood to ascertain all relevant, peer-reviewed articles from database inception to 27 December 2019.Study Selection: Studies were included if an association between an indicator of parental SES and a measure of child sleep (duration, quality, and problems) was reported. Data Extraction: Data was extracted from 46 studies (N=72,915). Across these studies, total sample size across participants included in the meta-estimate was N=69,373. Results: Higher parental education was associated with longer childhood sleep duration (stronger in samples with a higher proportion of White children) and better sleep quality. Parental education was not directly associated with child sleep problems; moderation occurred by continent and the relationship was more pronounced in the Asian meta-estimate. Higher household income was not directly associated with longer childhood sleep duration, but moderation occurred by higher quality studies and the proportion of White children in the sample. Higher household income was associated with fewer sleep problems (moderated by continent) and higher sleep quality. Limitations: This review was limited by the number and methods of available published studies meeting inclusion criteria.Conclusions: Preventative programs that emphasize improvements in sleep of children and adolescents growing up in lower SES families are needed.