Long-term mother and child mental health effects of a population-based infant sleep intervention: cluster-randomized, controlled trial.

Full Abstract

OBJECTIVES:
Maternal depression is an established risk for adverse child development. Two thirds of clinically significant depressive symptoms occur in mothers reporting an infant sleep problem. We aimed to determine the long-term effects of a behavioral intervention for infant sleep problems on maternal depression and parenting style, as well as on child mental health and sleep, when the children reached 2 years of age.

METHODS:
We conducted a cluster-randomized trial in well-child centers across 6 government areas of Melbourne, Australia. Participants included 328 mothers reporting an infant sleep problem at 7 months, drawn from a population sample (N = 739) recruited at 4 months. We compared the usual well-child care (n = 154) versus a brief behavior-modification program designed to improve infant sleep (n = 174) delivered by well-child nurses at ages 8 to 10 months and measured maternal depression symptoms (Edinburgh Postnatal Depression Scale); parenting practices (Parent Behavior Checklist); child mental health (Child Behavior Checklist); and maternal report of a sleep problem (yes or no).

RESULTS:
At 2 years, mothers in the intervention group were less likely than control mothers to report clinical depression symptoms:
15.4% vs 26.4% (Edinburgh Postnatal Depression Scale community cut point) and 4.2% vs 13.2% (Edinburgh Postnatal Depression Scale clinical cut point). Neither parenting style nor child mental health differed markedly between the intervention and control groups. A total of 27.3% of children in the intervention group versus 32.6% of control children had a sleep problem.

CONCLUSIONS:
The sleep intervention in infancy resulted in sustained positive effects on maternal depression symptoms and found no evidence of longer-term adverse effects on either mothers' parenting practices or children's mental health. This intervention demonstrated the capacity of a functioning primary care system to deliver effective, universally offered secondary prevention.

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Author information

Author/s: Hiscock, Harriet (H); Bayer, Jordana K (JK); Hampton, Anne (A); Ukoumunne, Obioha C (OC); Wake, Melissa (M);

Affiliation: Royal Children's Hospital, Centre for Community Child Health, Flemington Road, Parkville, Victoria 3052, Australia. harriet.hiscock(-atsign-)rch.org.au

Journal and publication information

Publication Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: Pediatrics (Pediatrics), published in United States. (Language: eng)

Reference: 2008-Sep; vol 122 (issue 3) : pp e621-7

Dates: Created 2008/09/02; Completed 2008/09/16;

PMID: 18762495, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Behavior Therapy - methods
Child Development - physiology
Depression - complications; epidemiology; therapy
Female
Follow-Up Studies
Humans
Incidence
Infant
Male

Male
Mental Health
Mother-Child Relations
Population Surveillance
Retrospective Studies
Risk Factors
Sleep Disorders - epidemiology; etiology; prevention & control
Time Factors
Treatment Outcome
Victoria - epidemiology

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