Bringing a new life into the world is a profound experience, but the emotional turbulence that often accompanies pregnancy and new motherhood can ripple through both mother and child.
“Depressive and anxiety symptoms are common during pregnancy and early motherhood,” said Shirong Cai, a Principal Scientist in the Translational Neuroscience Programme at the A*STAR Institute for Human Development and Potential (A*STAR IHDP), formerly known as the Singapore Institute for Clinical Sciences (SICS).
Much research has focused on depression and anxiety separately, often limited to clinically diagnosed cases. “Anxiety and depression are highly comorbid and correlated which makes it difficult to study them independently of one another,” said Cai. Cai’s team aimed to combine both conditions into a single measure to better reflect maternal mental health and its influence on infant sleep.
The multi-institutional team included Michael Meaney, Programme Director of Translational Neuroscience at A*STAR IHDP, and researchers from the National University of Singapore, National University Health System and KK Women’s and Children’s Hospital in Singapore; and McGill University in Canada.
They analysed data from 797 mother-child pairs enrolled in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. This included maternal mental health assessments during late pregnancy and three months postpartum, as well as infant sleep patterns in the first year.
Using bifactor analysis, the researchers clustered responses from anxiety and depression screening tools to create a general mental health score. Their findings revealed that babies of mothers with poor mental health during pregnancy were awake longer at night, whereas the same was not observed in babies whose mothers had poor mental health after birth.
“This suggests in utero exposure to poor maternal mental health has a programming effect on the fetus and subsequent behaviours,” Cai commented.
Changes in the fetal hypothalamic-pituitary-adrenal axis, could be one explanation, potentially affecting brain functions related to sleep.
The study also found that maternal sleep quality could mediate the impact of postpartum mental health on infant sleep. While poor maternal mental health at three months postpartum was linked to longer night awakenings in infants, this association weakened when the mother’s sleep quality was considered.
The team hopes these findings will encourage healthcare providers to prioritise emotional well-being during pregnancy to support both mother and child. They continue to explore the GUSTO dataset, searching for new risk factors influencing infant sleep.
The A*STAR-affiliated researchers contributing to this research are from the A*STAR Institute for Human Development and Potential (A*STAR IHDP).
