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    Maternal depressive symptoms in and beyond the perinatal period: Associations with infant and preschooler sleep
    (Oxford University Press on behalf of Sleep Research Society, 2024-10-29) Carter ML; Paine S-J; Sweeney BM; Taylor J; Signal TL
    Study Objectives (1) To describe sleep in infancy and early childhood among children born to mothers with and without clinically significant depressive symptoms, and (2) to explore the relationships between maternal depressive symptoms and sleep patterns and problems during infancy and early childhood. Methods Secondary analysis of longitudinal data from the Moe Kura: Mother and Child, Sleep and Wellbeing in Aotearoa/New Zealand study. Data were collected in pregnancy (T1), 12 weeks postpartum (T2), and 3 years post-birth (T3). Participants were 262 Māori and 594 non-Māori mother–child dyads. Chi-square and independent t-tests measured bivariate associations between maternal mood (T1, T2, and T3) and child sleep characteristics (T2 and T3). Binary logistic regression models examined longitudinal and concurrent associations between maternal depressive symptoms and infant and preschooler sleep. Adjusted models accounted for key socio-demographic variables, as well as infant sleep variables in preschooler models. Results Bivariate associations were found between prior and concurrent depressive symptomology and many of the infant and preschooler sleep outcomes. In adjusted models, prenatal depressive symptoms remained independently associated with shorter-than-recommended sleep durations in preschoolers. In these models, concurrent depression was also associated with night waking, night LSRSP, and perceived sleep problems at 12 weeks postpartum, and CSHQ-determined and perceived sleep problems at 3 years post-birth. Conclusions Longitudinal and cross-sectional associations were found between maternal depressive symptoms and child sleep. Sleep appears to be one pathway by which maternal depression confers risk for suboptimal child health outcomes. Findings support the need for earlier and better maternal mental health services.
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    Perinatal anxiety and sleep : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Albany, New Zealand
    (Massey University, 2023) Russell, Sonya Jane
    Introduction. Anxiety symptoms and sleep health issues are common during the perinatal period. Few studies have investigated differences in prevalence of these issues for Māori and non-Māori women and considered the relationships between anxiety and sleep across this timeframe. Objective. This study investigated the prevalence of anxiety symptoms in a large community sample of Māori and non-Māori women, and the cross-sectional and longitudinal relationships between anxiety and sleep from late pregnancy through to 3 months postpartum. Methods. The longitudinal Moe Kura cohort study collected self-report data from 1144 women (406 Māori and 738 non-Māori) at several time points (prior to pregnancy, late pregnancy, 4-6 weeks postpartum and 12 weeks postpartum). Pearson’s chi-square tests and univariate analyses were calculated to understand the sample and binary logistic regression models were used to investigate cross-sectional and longitudinal relationships. Results. Results indicated bi-directional relationships between anxiety and sleep health at several time points across the perinatal period. Women with long sleep latencies were more than twice as likely to experience high anxiety symptoms (OR=2.11 at T2 and 2.71 at T4) and vice versa (OR=2.11 at T2 and 2.66 at T4). In late pregnancy, short sleep, daytime sleepiness and leg twitching/jerking, had a bi-directional relationship with high anxiety symptoms but this was not seen at other time points. Longitudinal analyses showed that high anxiety symptoms in late pregnancy were predictive of high anxiety symptoms postpartum. Conclusion. The bi-directional nature of the relationship between long sleep latency and high anxiety symptoms could be used to develop questions to ask women so these issues can be identified and followed up. This is critical, as the most consistent predictor of high anxiety symptoms postpartum was high anxiety symptoms in late pregnancy. This study also highlights the high prevalence of anxiety and sleep health issues in pregnancy and the importance of ensuring identification, treatment and support of women across the perinatal period. The Kaupapa Māori principles incorporated in the design and implementation of the Moe Kura cohort study enables valuable insights into the experiences of Māori and non-Māori women and the differences between them.