Stressful life events in pregnancy and sleep problems in childhood: Evidence from the ELSPAC Cohort

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Abstract Background Childhood sleep problems have been associated with adjustment difficulties; furthermore, early-onset sleep problems may persist over the life course. Exposure to stress during pregnancy may be a risk factor for developing sleep problems in childhood due to its effect on the stress reactivity in the child. In the current study, we examined the association between prenatal stressful life events (SLE) and childhood sleep problems, paying attention to their trajectory over time. Methods Data were obtained from the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ; N = 4,371 mother-child dyads). Mothers reported SLE during pregnancy using an inventory of 42 life events and the number of child sleep problems at the child's age of 18 months and 3, 5, 7, and 11 years. The association between prenatal SLE and the developmental course of sleep problems was examined using a Poisson latent growth model. The model was adjusted for maternal and family demographics, birth characteristics, and maternal depression. Results At 18 months, mothers reported on average 2.01 sleep problems (range 0-7, p < 0.001). The rate of sleep problems decreased linearly by 0.89 (p < 0.001) per year. A higher number of prenatal SLE was associated with a higher rate of sleep problems at 18 months (rate ratio [RR]=1.02, 95% confidence interval [CI]=1.01-1.02, p < 0.001), and significantly reduced rate of decrease in sleep problems from 18 months to 11 years (p < 0.001). Conclusions Exposure to prenatal SLE was associated with a higher number of sleep problems in early childhood and with their persistence over time. Thus, experiencing prenatal stress may serve as a predisposing factor for the development of sleep problems later in life. Key messages Children of mothers who experienced stressful life events in pregnancy had more sleep problems during childhood. Prenatal exposure to stress may predispose individuals to sleep problems later in life.