Susan Garthus-Niegel1, Antje Horsch2, Myriam Bickle Graz3, Julia Martini4, Tilmann von Soest5, Kerstin Weidner6, Malin Eberhard-Gran7. 1. Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine,Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Department of Child Health, Norwegian Institute of Public Health, P.O. box 222 Skøyen, 0213 Oslo, Norway. Electronic address: susan.garthus-niegel@uniklinikum-dresden.de. 2. Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland; Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, Lausanne University and Lausanne University Hospital, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland. 3. Department Woman-Mother-Child, Faculty of Biology and Medicine, Lausanne University Hospital, Rue du Bugnon 21, CH-1011 Lausanne, Switzerland. 4. Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany. 5. Department of Psychology, University of Oslo, P.O. box 1094, Blindern, 0317 Oslo, Norway. 6. Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine,Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany. 7. Department of Child Health, Norwegian Institute of Public Health, P.O. box 222 Skøyen, 0213 Oslo, Norway; HØKH, Research Centre, Akershus University Hospital, P.O. box 1000, 1478 Lørenskog, Norway; Institute of Clinical Medicine, Campus Ahus, University of Oslo, P.O. box 1171, Blindern, 0318 Oslo, Norway.
Abstract
BACKGROUND: The main aim of this study was to examine the prospective impact of maternal postpartum PTSD on several standardized child sleep variables two years postpartum in a large, population-based cohort of mothers. Moreover, we investigated the influence of numerous potential confounding maternal and child factors. Finally, we tested potential reverse temporal associations between child sleep eight weeks postpartum and maternal PTSD symptoms two years postpartum. METHODS: This study is part of the population-based Akershus Birth Cohort, a prospective cohort study at Akershus University Hospital, Norway. Data from the hospital's birth record, from questionnaires at 17 weeks gestation, eight weeks and two years postpartum were used. At two years postpartum, 39% of the original participants could be retained, resulting in a study population of n = 1480. All child sleep variables significantly correlated with postpartum PTSD symptoms were entered into multiple linear regression analyses, adjusting for confounding factors. RESULTS: Postpartum PTSD symptoms were related to all child sleep variables, except daytime sleep duration. When all significant confounding factors were included into multivariate regression analyses, postpartum PTSD symptoms remained a significant predictor for number and duration of night wakings (β = 0.10 and β = 0.08, respectively), duration of settling time (β = 0.10), and maternal rating of their child's sleep problems (β = 0.12, all p<.01. Child sleep at eight weeks postpartum was not significantly related to maternal sleep two years postpartum when controlling for postpartum PTSD at eight weeks. LIMITATIONS: Child outcomes were based on maternal reporting and might be influenced by maternal mental health. CONCLUSIONS: Our results showed for the first time that maternal postpartum PTSD symptoms were prospectively associated with less favorable child sleep, thus increasing the risk of developmental or behavioral problems through an indirect, but treatable pathway. Early detection and treatment of maternal postpartum PTSD may prevent or improve sleep problems and long-term child development.
BACKGROUND: The main aim of this study was to examine the prospective impact of maternal postpartum PTSD on several standardized child sleep variables two years postpartum in a large, population-based cohort of mothers. Moreover, we investigated the influence of numerous potential confounding maternal and child factors. Finally, we tested potential reverse temporal associations between child sleep eight weeks postpartum and maternal PTSD symptoms two years postpartum. METHODS: This study is part of the population-based Akershus Birth Cohort, a prospective cohort study at Akershus University Hospital, Norway. Data from the hospital's birth record, from questionnaires at 17 weeks gestation, eight weeks and two years postpartum were used. At two years postpartum, 39% of the original participants could be retained, resulting in a study population of n = 1480. All child sleep variables significantly correlated with postpartum PTSD symptoms were entered into multiple linear regression analyses, adjusting for confounding factors. RESULTS: Postpartum PTSD symptoms were related to all child sleep variables, except daytime sleep duration. When all significant confounding factors were included into multivariate regression analyses, postpartum PTSD symptoms remained a significant predictor for number and duration of night wakings (β = 0.10 and β = 0.08, respectively), duration of settling time (β = 0.10), and maternal rating of their child's sleep problems (β = 0.12, all p<.01. Child sleep at eight weeks postpartum was not significantly related to maternal sleep two years postpartum when controlling for postpartum PTSD at eight weeks. LIMITATIONS: Child outcomes were based on maternal reporting and might be influenced by maternal mental health. CONCLUSIONS: Our results showed for the first time that maternal postpartum PTSD symptoms were prospectively associated with less favorable child sleep, thus increasing the risk of developmental or behavioral problems through an indirect, but treatable pathway. Early detection and treatment of maternal postpartum PTSD may prevent or improve sleep problems and long-term child development.
Authors: Sergio Martínez-Vazquez; Julián Rodríguez-Almagro; Antonio Hernández-Martínez; Miguel Delgado-Rodríguez; Juan Miguel Martínez-Galiano Journal: J Clin Med Date: 2021-01-30 Impact factor: 4.241