Maternal-Infant Bedsharing Associated with Maternal Depressive Symptoms and Perception of Infant Sleep

Abstract

Abstract Objectives This study examines nighttime mother-infant sleep arrangements across the first 15 months of life, identifies maternal and infant predictors of bedsharing, and tests the relationship between breastfeeding and bedsharing. Methods We used data from 428 African-American mother-infant pairs participating in the Mothers & Others Study, a home-based intervention to prevent early development of obesity. Data were collected at 28 weeks pregnancy and 3, 6, 9, 12, and 15 months postpartum. Infant sleep variables were measured using the Brief Infant Sleep Questionnaire. A multinomial mixed-effects model tested for associations between maternal and infant explanatory variables (e.g., sociodemographic variables, maternal report of infant sleep as a problem (ISP), maternal depressive symptoms (MDS), and breastfeeding duration) and infant sleep arrangement (bedsharing, room-sharing, and separate rooms). A similar, cross-lagged model simultaneously tested cross-sectional and bidirectional associations between ISP, MDS, and bedsharing, controlling for important covariates. Results The prevalence of bedsharing increased over time with 16.7% of mothers reporting bedsharing at 1 month postpartum and 35.6% at 15 months postpartum. Maternal perception of ISP and MDS were each associated with bedsharing in both cross-sectional [(RRISP: 1.90; 95% CI: 1.21–2.99), (RRMDS: 1.62; 95% CI: 1.04–2.52)] and lagged models [(RRISP: 1.82; 95% CI: 1.11–2.99), (RRMDS: 1.66; 95% CI: 1.07–2.58)]. Lagged MDS moderated the effect of lagged maternal perception of ISP, such that among mothers who had previously perceived their infants to have a sleep problem, those with prior depressive symptoms were almost six times more likely to report bedsharing at the next visit (RR: 5.56; 95% CI: 1.31–23.65), in adjusted models. Greater length of breastfeeding duration was associated with an increased likelihood of room-sharing (RR: 1.20; 95% CI: 1.06–1.36), versus bedsharing. Conclusions Our analysis shows that infant sleep location is associated with maternal depression, perception of infant sleep, and household characteristics. More research is needed to improve our understanding of the mechanisms underlying these relationships. Funding Sources The National Institute of Child Health and Human Development.