Peripartum depression and infant care, sleep and growth.
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ABSTRACT:
SUBMITTER: Iwata S
PROVIDER: S-EPMC6629993 | biostudies-literature | 2019 Jul
REPOSITORIES: biostudies-literature
Publications
Peripartum depression and infant care, sleep and growth.
Iwata Sachiko S Kinoshita Masahiro M Fujita Fumie F Tsuda Kennosuke K Unno Mitsuaki M Horinouchi Takashi T Morokuma Seiichi S Saitoh Shinji S Iwata Osuke O
Scientific reports 20190715 1
Peripartum depression is a common, serious complication in mothers. To assess the influence of infant care, sleep and growth on the risk of peripartum depression, 1,271 mothers of healthy one-month-old infants completed comprehensive questionnaires including the Edinburgh Postnatal Depression Scale. Relationships between high depression scores and variables related to infants' care, sleep and growth were assessed adjusting for other variables. High depression scores were found in 233 mothers, wh ...[more]
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Project description:ObjectiveA number of studies have established an association between antenatal maternal depression and infant sleep. One key question is whether all infants are equally susceptible to environmental influences, including the intrauterine environment. Reactive temperament has been examined as a plasticity factor, with accumulating evidence suggesting that infants with reactive temperament may be more susceptible to both positive and negative environmental influences. This study examines whether infant reactivity moderates any association between antenatal depression and infant sleep in 2 longitudinal studies: the Avon Longitudinal Study of Parents and Children (ALSPAC) and Generation R cohorts.MethodsMaternal depression scores were assessed during pregnancy using Edinburgh Postnatal Depression Scale and Brief Symptom Inventory. Infant sleep duration and awakenings, in ALSPAC (N = 8318) and Generation R (N = 2241), were assessed at 18 and 24 months of age, respectively. Infant reactivity was assessed by temperament questionnaire at 6 months of age.ResultsHierarchical linear regression models indicated a 3-way interaction between reactivity and gender moderating the effect of antenatal depression on infant sleep, on sleep duration in Generation R at 24 months (β = .085, p < .001) in the whole sample and when limited to the Dutch/European group (β = .055, p = .030), and on night awakenings at 18 months in ALSPAC (β = -.085, p = .013). Boys with more reactive temperament exhibited shorter sleep duration and a higher number of awakenings when previously exposed to maternal symptoms of antenatal depression.ConclusionFor the first time, these findings highlight, in 2 large cohorts, that children with temperamental reactivity may be more vulnerable to antenatal depression, raising the possibility of targeted interventions to improve infant outcomes.
| S-EPMC4497971 | biostudies-literature
Project description:The study assessed how the timing of maternal perinatal depressive symptoms affects infant socio-emotional characteristics at age 18 months. The study was a longitudinal cohort study that included six assessment points from the third trimester of pregnancy up to age 18 months (±1 month). Assessment of mothers included the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory, while assessments of infant included the Infant Toddler Social and Emotional Assessment (ITSEA) at 18 months. Mothers were categorized into one of the following groups: mothers who presented postnatal depression only (n = 19); mothers who presented both prenatal and postnatal depression (n = 14), and mothers who never showed perinatal depression symptoms (n = 38). Mothers who presented both prenatal and postnatal depression showed significantly higher levels of depressive score, reactivity to stress and level of anxiety trait compared to mothers of the two other groups. Infants of prenatally and postnatally depressed mothers had higher scores on the internalizing subscore of the ITSEA. The number of depression episodes during the study period was positively correlated with the externalizing and internalizing subscores of the ITSEA. These findings support the need to provide specific screening to identify women with prenatal depression.
| S-EPMC9735611 | biostudies-literature
Project description:BackgroundPeripartum depression is a leading cause of disease burden for women and yet there is little evidence as to how often peripartum depression does not respond to treatment and becomes treatment resistant depression. We sought to determine the incidence of treatment resistant depression (TRD) in women with peripartum depression.MethodsPopulation based retrospective cohort study using a large US claims database. Peripartum depression was defined as having a depression diagnosis during pregnancy or up to 6 months after the end of pregnancy. We included women with prevalent or incident depression. The outcome was the development of TRD within 1 year after the diagnosis of peripartum depression. TRD was defined as having 3 distinct antidepressants or 1 antidepressant and 1 antipsychotic in 1 year. Women with peripartum depression may not be exposed to pharmacological treatments early in pregnancy, therefore we created two groups: 1. women with peripartum depression, and 2. women with peripartum depression diagnosed 3 months before a live birth delivery or within 6 months after that delivery.ResultsThere were 3,207,684 pregnant women, of whom 2.5% had peripartum depression. Of these women half had incident depression during pregnancy. Five percent of women with peripartum depression developed TRD within 1 year of the depression diagnosis. The risk of developing TRD was 50% higher in women with prevalent depression than in women with incident peripartum depression (P < 0.0001). Results were similar in women with peripartum depression diagnosed later in their pregnancy. Women who went on to develop TRD had more substance use disorders, anxiety, insomnia and painful conditions.ConclusionsTRD occurs in approximately 5% of women with peripartum depression. The risk of TRD is higher in pregnant women with a history of depression. Women who went on to develop TRD had more psychiatric comorbidities and painful conditions than women who did not.
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Project description:To examine the psychological well-being of mothers following participation in a behavioural modification programme previously shown to improve infant sleep. A 45 min consultation with either a general practitioner (GP) or trained nurse providing verbal and written information describing sleep physiology in infants and strategies to improve infant sleep. Eighty mothers of infants 6-12 months of age with established infant sleep problems at a single general practice, Adelaide, South Australia. The Depression Anxiety Stress Scale 21 (DASS21) immediately prior to the first consultation and again at follow-up approximately 3 weeks later. The number of infant nocturnal awakenings requiring parental support was also reported by mothers on both occasions. All measures of maternal well-being and infant nocturnal awakenings improved significantly. The mean number of maximum nocturnal awakenings decreased from 5.0 to 0.5 (mean difference 4.4, 95% CI 3.4 to 5.5). All measures of DASS21 improved significantly. The mean total DASS21 decreased from 29.1 to 14.9 (mean decrease 14.2, 95% CI 10.2 to 18.2); mean depression decreased from 7.9 to 2.8 (mean difference 5.2, 95% CI 3.7 to 6.7); mean anxiety decreased from 4.6 to 2.6 (mean difference 2.0, 95% CI 0.7 to 3.2); mean stress decreased from 16.6 to 9.5 (mean difference 7.0, 95% CI 5.1 to 9.0). The proportion of mothers assessed as having any degree of depression decreased by 85% from 26/80 (32.5%) to 4/80 (5%). The number of nocturnal awakenings requiring parental support among infants aged 6-12 months significantly decreased following a single consultation on infant sleep physiology and teaching behavioural strategies to improve sleep. Significant improvements in maternal stress, anxiety and depression were also observed.
| S-EPMC3467591 | biostudies-literature
Project description: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.
| S-EPMC9234523 | biostudies-literature
Project description:Obstetrical perineal and anal sphincter lacerations can be associated with considerable sequelae. The diagnosis of short-term bowel, bladder, and healing problems can be delayed if patients are not seen until the traditional postpartum visit at 4 to 6 weeks. Specialized peripartum clinics create a unique opportunity to collaborate with obstetrical specialists to provide early, individualized care for patients experiencing a variety of pelvic floor issues during pregnancy and in the postpartum period. Although implementation of these clinics requires thoughtful planning and partnering with care providers at all levels in the obstetrics care system, many of the necessary resources are available in routine gynecologic practice. Using a multidisciplinary approach with pelvic floor physical therapists, nurses, advanced practice providers, and other specialists is important for the success of this service line and enhances the level of care provided. Overall, these clinics provide a structured means by which pregnant and postpartum women with pelvic floor symptoms can receive specialized counseling and treatment.
| S-EPMC7720615 | biostudies-literature
Project description:BackgroundAlthough the effects of maternal behavior on the development of child emotion characteristics is relatively well-established, effects of infant characteristics on maternal emotion development is less well known. This gap in knowledge persists despite repeated calls for including child-to-mother effects in studies of emotion. We tested the theory-based postulate that infant temperamental negativity moderates longitudinal trajectories of mothers' perinatal symptoms of anxiety and depression.MethodParticipants were 92 pregnant community women who enrolled in a longitudinal study of maternal mental health; symptoms of anxiety and depression were assessed during the second and third trimesters of pregnancy and again at infant age 4 months. A multimethod assessment of infants' temperament-based negative reactivity was conducted at infant age 4 months.ResultsMaternal symptoms of anxiety showed smaller postnatal declines when levels of infant negativity were high. Negative reactivity, assessed via maternal report of infant behavior, was related to smaller postnatal declines in maternal anxiety, while infant negative reactivity, at the level of neuroendocrine function, was largely unrelated to longitudinal changes in maternal anxiety symptoms. Infant negativity was related to early levels, but largely unrelated to trajectories of maternal symptoms of depression.LimitationsLimitations of this work include a relatively small and low-risk sample size, the inability to isolate environmental effects, and a nonexperimental design that precludes causal inference.ConclusionsFindings suggest that levels of infant negativity are associated with differences in the degree of change in maternal anxiety symptoms across the perinatal period.
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Project description:ObjectivesPerinatal depression has been found to be a strong and independent risk factor for poor child growth and development in low-income South Asian populations. The authors aimed to study if there was a similar association in first and second-generation British women of Pakistani origin.DesignA prospective cohort study.SettingThe study was conducted in the North-West of England, in areas with high density of Pakistani-origin population. The subjects were recruited from Central Manchester Hospital in the City of Manchester and East Lancashire Hospital in Lancashire.Participants704 physically healthy women were assessed in two phases (screening and detailed assessment of high scorers and a proportion of low scorers) during the third trimester of pregnancy to obtain at birth a cohort of 63 infants of depressed mothers and 173 infants of psychologically well mothers.Primary and secondary outcome measuresAll infants were weighed and measured at birth and 6 months, and their development was assessed using the Bayley Scales of Infant Development-Third Edition.ResultsThere was no difference in the birth weight or weight and height at 6 months of infants of depressed mothers versus infants of psychologically well mothers. The only significant difference between the two groups was in the infants' adaptive behaviour; infants of depressed mothers scored significantly lower than those of psychologically well mothers (mean difference 4.6, t=2.81, df 195, p=0.006). The associations remained significant after adjustment for socio-demographic factors by multivariate analyses.ConclusionsPrenatal depression is not associated with impaired growth in this sample of British Pakistani women. There is, however, an association of prenatal depression with parent-reported problems in the infants' adaptive behaviour. Further research is needed to understand various pathways through which maternal depression affects infant outcomes in low- and high-income settings.
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Project description:Sleep consolidates memory and promotes generalization in adults, but it is still unknown to what extent the rapidly growing infant memory benefits from sleep. Here we show that during sleep the infant brain reorganizes recent memories and creates semantic knowledge from individual episodic experiences. Infants aged between 9 and 16 months were given the opportunity to encode both objects as specific word meanings and categories as general word meanings. Event-related potentials indicate that, initially, infants acquire only the specific but not the general word meanings. About 1.5 h later, infants who napped during the retention period, but not infants who stayed awake, remember the specific word meanings and, moreover, successfully generalize words to novel category exemplars. Independently of age, the semantic generalization effect is correlated with sleep spindle activity during the nap, suggesting that sleep spindles are involved in infant sleep-dependent brain plasticity.
| S-EPMC4316748 | biostudies-other
Project description:The effect of cumulative biological, psychosocial, and demographic risk and infant sleep on infant social-emotional functioning in 12-month-old infants (46% female) was examined in data from racially (30% Black, 60% White, 10% multiracial/other) and socioeconomically (41% below median income) diverse caregivers (N = 468, M = 30.42 years old, SD = 5.65) recruited from two midwestern states in 2019-2020. Due to the major changes in sleep patterns during infancy and the reported association between sleep and social-emotional functioning, this study also examined whether sleep moderates the association between risk and infant social-emotional functioning and potentially promotes healthy social-emotional functioning despite risk. Greater cumulative risk was associated with poorer sleep efficiency and more social-emotional problems, but was not associated with the general acquisition of social-emotional milestones. Results also suggested that poorer sleep efficiency was associated with more social-emotional problems and poorer social-emotional milestone acquisition. No significant interaction effects were found between cumulative risk and infant sleep. Risk and sleep appear to have unique associations with infant social-emotional problems and development; thus both could be targeted in early intervention to promote social-emotional functioning during infancy and early childhood.
| S-EPMC9526438 | biostudies-literature