Prospective Associations Between Maternal Depression and Infant Sleep in Women With Gestational Diabetes Mellitus

Abstract

BackgroundWomen with gestational diabetes mellitus have higher rates of perinatal depressive symptoms, compared to healthy pregnant women. In the general population, maternal depressive symptoms have been associated with infant sleep difficulties during the first year postpartum. However, there is lack of data on infants of mothers with gestational diabetes mellitus.MethodsThis study assessed the prospective associations between maternal perinatal depressive symptoms and infant sleep outcomes. The study population consisted of 95 Swiss women with gestational diabetes mellitus and their infants, enrolled in the control group of the MySweetheart trial (NCT02890693). Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale at the first gestational diabetes mellitus visit during pregnancy, at 6–8 weeks postpartum, and 1 year postpartum. The Brief Infant Sleep Questionnaire was used to assess infant sleep (i.e., nocturnal sleep duration, number of night waking, and maternal perception of infant sleep) at 1 year postpartum. Relevant maternal and infant measurements (e.g., infant sex or maternal age or social support) were collected or extracted from medical records as covariates.ResultsAntenatal maternal depressive symptoms at the first gestational diabetes mellitus visit were inversely associated with infant nocturnal sleep duration at 1 year postpartum (β = –5.9, p = 0.046). This association became marginally significant when covariates were added (β = –5.3, p = 0.057). Maternal depressive symptoms at 6–8 weeks postpartum were negatively and prospectively associated with infant nocturnal sleep duration (β = –9.35, p = 0.016), even when controlling for covariates (β = –7.32, p = 0.042). The association between maternal depressive symptoms and maternal perception of infant sleep as not a problem at all was significant at 1 year postpartum (β = –0.05, p = 0.006), although it became non-significant when controlling for appropriate covariates. No other significant associations were found.LimitationsThis study solely included measures derived from self-report validated questionnaires.ConclusionOur findings suggest it is of utmost importance to support women with gestational diabetes mellitus as a means to reduce the detrimental impact of maternal perinatal depressive symptoms on infant sleep, given its predictive role on infant metabolic health.

Maternal Mental Health Symptom Profiles and Infant Sleep: A Cross-Sectional Survey

“…This leads to the third limitation of this study, which was the lack of MMH measurement during pregnancy. Indeed, antenatal maternal depression symptoms were prospectively associated with infant sleep [ 16 , 28 ]. Thus, the current study would have benefitted from controlling for antenatal MMH symptoms.…”

“…The first purpose of the current study was to examine the associations between maternal symptoms of postpartum depression, anxiety, or CB-PTSD and infant sleep (i.e., night waking and nocturnal sleep duration). Based on the literature, we hypothesized that MMH symptoms are positively associated with infant night waking, but negatively with nocturnal sleep duration [ 4 , 19 , 28 ]. Given that postpartum depression, anxiety, and CB-PTSD are comorbid [ 14 , 25 , 26 , 27 ], the second aim consisted of extracting data-driven MMH symptom profiles.…”

Swiss cohort on Traumatic Childbirth and Health (SwiTCH): protocol for a prospective, population-based cohort study on parents’ mental health from pregnancy to one year postpartum

“…The mMOS-SS 47 is an 8-item scale assessing social support. In the absence of a validated French version of the mMOS-SS, a French version that has already been used in Switzerland 48 has been used in the present study.…”

Effect of the MySweetheart randomized controlled trial on birth, anthropometric and psychobehavioral outcomes in offspring of women with GDM

“…This may also indirectly affect the offspring’s psychobehavioral outcomes. Indeed, maternal depression in women with GDM is associated with shorter sleep duration in the offspring at one year of age, which may in turn negatively impact the offspring’s development ( 18 ). In women with obesity, maternal perception of offspring difficult behavior is also more frequent and is associated with poorer offspring development, such as low mood and inadaptability up to 12 years of age; however, this still needs to be investigated in GDM populations ( 19 , 20 ).…”