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Meta-Analysis
. 2022 Dec 1;43(9):e629-e644.
doi: 10.1097/DBP.0000000000001123. Epub 2022 Sep 2.

Perinatal Physiological and Psychological Risk Factors and Childhood Sleep Outcomes: A Systematic Review and Meta-analysis

Ying Dai  1 , Kimberly Kovach Trout, Jianghong Liu
Affiliations
Meta-Analysis

Perinatal Physiological and Psychological Risk Factors and Childhood Sleep Outcomes: A Systematic Review and Meta-analysis

Ying Dai et al. J Dev Behav Pediatr. .

Abstract

Objectives: The purpose of this study was to investigate the influence of maternal physiological and psychological factors during pregnancy and after birth on infant and children's sleep outcomes.

Methods: Six databases were searched from inception to April 2021. Longitudinal studies that investigated the association of risk factors during and after pregnancy and children's sleep-related outcomes were included. Hedge's g and odds ratio were pooled as effect size with random effects model.

Results: A total of 32 articles were included. Both prenatal maternal alcohol use (odds ratio [OR] = 1.85, 95% confidence interval [CI]: 1.04-3.28) and tobacco smoking (OR = 1.28, 95% CI: 1.01-1.62) were associated with shorter child sleep duration. Prenatal and postnatal maternal depression symptoms were associated with increased child sleep problems at age 6 months (OR = 1.97, 95% CI: 1.19-3.24, and 2.05, 95% CI: 1.37-3.07, respectively). Prenatal and postnatal maternal major depression disorders were associated with shorter sleep duration (Hedge's g = -0.97, 95% CI: -1.57 to -0.37) and lower sleep efficiency (Hedge's g = -1.44, 95% CI: -1.93 to -0.95). Prenatal anxiety had no impact on child sleep problems (OR = 1.34, 95% CI: 0.86-2.10).

Conclusion: Maternal pregnancy and obstetric factors and psychological factors are potential risk factors of poor child sleep health. Future research is warranted to better understand the impact of these risk factors on long-term child sleep outcomes and their potential mediating mechanisms.

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Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram
Figure 2
Figure 2
Effects of the association between prenatal alcohol drinking and child short sleep duration (yes/no). A random effects model was used to calculate the pooled estimate of the odds ratio (OR) and its 95% confidence interval (CI). The area of each symbol is proportional to the weight of the study. The diamond represents the pooled effect (OR 5 1.85, 95% CI: 1.04–3.28, p 5 0.0352, I2 5 21.6%).
Figure 2
Figure 2
Effects of the association between prenatal alcohol drinking and child short sleep duration (yes/no). A random effects model was used to calculate the pooled estimate of the odds ratio (OR) and its 95% confidence interval (CI). The area of each symbol is proportional to the weight of the study. The diamond represents the pooled effect (OR 5 1.85, 95% CI: 1.04–3.28, p 5 0.0352, I2 5 21.6%).
Figure 3
Figure 3
Effects of the association between prenatal maternal tobacco smoking and child short sleep duration (yes/no). A random effects model was used to calculate the pooled estimate of the odds ratio (OR) and its 95% confidence interval (CI). The area of each symbol is proportional to the weight of the study. The diamond represents the pooled effect (OR 5 1.28, 95% CI: 1.01–1.62, p 5 0.0437, I2 5 0).
Figure 4
Figure 4
Effect size of the association between prenatal and postnatal maternal depression symptoms and child sleep problems (yes/no). A random effects model was used to calculate the pooled estimate of the odds ratio (OR) and its 95% confidence interval. The area of each symbol is proportional to the weight of the study.
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