Maternal depressive symptoms and mother-infant co-sleeping (including room sharing and bedsharing): a systematic review.

Abstract

Maternal depressive symptoms (MDS) affect most women during the first year postpartum. Mothers provide most of the nighttime care for infants, so studying the relationship between MDS and infant sleep location (ISL) is highly relevant to understanding maternal mental health over the first year of life and beyond. Infant sleep is studied by anthropologists, health care providers, and psychologists, with very little communication across disciplines. This review aimed to determine if there is a predictive relationship between MDS and ISL. This systematic review searched six databases with terms related to maternal mood and ISL. Final analysis included 14 published studies, analyzed with narrative synthesis and PRISMA guidelines. Included studies directly compared infant sleep location (ISL) and maternal depressive symptoms (MDS). Five studies showed no relationship between ISL and MDS, and one study found bedsharing reduced MDS. Five studies found co-sleeping was related to higher MDS although directionality is mixed or missing, and three studies found an association at some ages or for some populations only. Examining studies according to type of infant sleep assessment, study design, age of infant, or breastfeeding status failed to detect consistent patterns. A variety of study designs, types and definitions of variable measures, sample recruitment and study outcomes prevent detection of a consistent relationship between MDS and ISL. We explore reasons for the elusive nature of a relationship and make recommendations for future research in MDS and ISL, including cross-disciplinary collaborations.