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Association of maternal prenatal depression and anxiety with toddler sleep: the China-Anhui Birth Cohort study

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A Correction to this article was published on 26 February 2022

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Abstract

Maternal prenatal depression is associated with child sleep. We investigated whether maternal depression comorbid with anxiety worsens toddler’s sleep problems in a prospective cohort study. A total of 1583 mother-infant pairs from the China-Anhui Birth Cohort study were examined. The participants completed the Center for Epidemiologic Studies Depression Scale (CES-D) and Self-Rating Anxiety Scale (SAS) at 30–34 weeks of gestation, and the Edinburgh Postnatal Depression Scale (EPDS) at 3-month postpartum. Toddler’s sleep was assessed by the Brief Infant Sleep Questionnaire (BISQ) at 30 months old. Logistic regression models were used to investigate the associations between prenatal depression and anxiety and toddler’s sleep, while adjusting for maternal gestational age, education, family income, alcohol use, premature birth, fetal growth restriction, mode of delivery, postnatal depression, and 3-month breastfeeding. In total, 9.0% of participants reported prenatal depression comorbid with anxiety symptoms, and the prevalence of depression, anxiety was 6.7% and 7.3%, respectively. Compared with mothers without depression and anxiety, maternal depression combined with anxiety were significantly associated with shorter total sleep duration (11.16 ± 1.06 h), longer settling time (29.25 ± 23.57 min), and higher risk of toddlers’ sleep problems assessed by BISQ (OR = 2.09, 95% CI: 1.22–3.57) or parental report (OR = 1.84, 95% CI: 1.22–2.77). However, there was no significant association between maternal postnatal depression and toddler sleep behaviors. Maternal prenatal depression comorbid with anxiety significantly associated with poorer toddler’s sleep. Strategies to regulate prenatal mood status should be considered during prenatal health care to improve children’s sleep development.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy and ethical restrictions.

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Acknowledgements

The authors are grateful to the participants in the C-ABCS and staff in Hefei Maternal and Child Health Hospital in this study for their support in the data collection.

Funding

This study was supported by grants from the National Natural Science Foundation of China (81872631, 82173531) and Foundation for Scientific Research Improvement of Anhui Medical University (2021xkjT009).

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Author notes

  1. Shuangshuang Ma and Xiaoguang Yin contributed equally to this study.

Authors and Affiliations

  1. Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Shuangshuang Ma, Jun Xie, Pei Li & Peng Zhu

  2. MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Shuangshuang Ma, Jun Xie, Pei Li & Peng Zhu

  3. NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Shuangshuang Ma, Jun Xie, Pei Li & Peng Zhu

  4. Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China

    Shuangshuang Ma, Jun Xie, Pei Li & Peng Zhu

  5. Department of Neonatology, Anhui Maternal and Child Health Hospital, Hefei, 230001, Anhui, China

    Xiaoguang Yin

  6. Department of Obstetrics and Gynecology, First People’s Hospital of Hefei, Hefei, 230031, Anhui, China

    Ruixue Tao

  7. Department of Obstetrics and Gynecology, Anhui Women and Child Health Care Hospital, Hefei, 230001, Anhui, China

    Xiaomin Jiang

  8. Department of Psychiatry, Fourth People’s Hospital of Hefei, Hefei, 230022, Anhui, China

    Daomin Zhu

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  1. Shuangshuang Ma
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  8. Peng Zhu
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Contributions

DMZ and PZ conceived and designed the present study. SSM, XGY, DMZ, RXT, JX, PL, XMJ involved in data collection. SSM, JX, and PL performed the statistical analysis. SSM wrote the first draft of the manuscript, XGY contributed with their expertise in the research field. PZ critically reviewed the manuscript for accuracy and intellectual content. All authors contributed to the manuscript revision, and all read and approved the final draft.

Corresponding authors

Correspondence to Daomin Zhu or Peng Zhu.

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Ma, S., Yin, X., Tao, R. et al. Association of maternal prenatal depression and anxiety with toddler sleep: the China-Anhui Birth Cohort study. Arch Womens Ment Health 25, 431–439 (2022). https://doi.org/10.1007/s00737-021-01200-w

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  • DOI: https://doi.org/10.1007/s00737-021-01200-w

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