Perinatal & Pediatric
Maternal Mental Health and Infant Safe Sleep Practices: A Population-Based Analysis of PRAMS Data Jaksen Perrin* Andrew Williams Williams Williams Williams University of North Dakota
Background: Despite a 50 percent reduction in sudden unexpected infant death (SUID) attributed to safe sleep campaigns over the past 30 years, approximately 3,500 infants die from SUID in the United States. Maternal mental health factors may be associated with safe sleep environments yet is an underexamined determinant of safe sleep. We examined the association between maternal mental health and safe sleep environments, and if safe sleep recommendations moderate observed association.
Methods: North Dakota 2017-2021 PRAMS participants (weighted n=32,647), self-reported preconception, antenatal, and postpartum depression diagnoses. Participants reported on 8 infant sleep environment factors (e.g. sleep position, toys in crib, sleeping with blanket), and whether a healthcare professional discussed safe sleep recommendations during pregnancy. Logistic regression models estimated odds ratio (OR) and 95% confidence intervals (CIs) for the association between maternal depression and unsafe infant sleep factors for preconception, antenatal, and postpartum depression. Models were adjusted for maternal demographic and health factors and weighted to account for survey design.
Results: Depression during pregnancy was a risk factor for toys in cribs (OR:2.24; CI:1.35-3.73) and placing their infant on a chair to rest (OR:1.78; CI:1.16-2.73). Smoking was a risk factor for use of an infant sleep sack (OR:1.63; CI:1.04-2.54). Postpartum depression was a risk factor for sleeping on a large mattress (OR:1.71; CI:1.19-2.46).
Conclusion: These findings highlight the importance of safe sleep recommendations for mothers with a mental health status to improve infant sleep environments. Healthcare providers should prioritize outreach to mothers with mental health conditions.