Related Experiment Video
Updated: Jun 10, 2025
Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
Published on: June 13, 2021
Association between maternal stress and child sleep quality: a nationwide ECHO prospective cohort study
Sarah Dee Geiger1,2, Aruna Chandran3, Marie L Churchill3
1Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA. smurphy7@illinois.edu.
Insights
Maternal stress during pregnancy and after birth is linked to childhood sleep problems. Postnatal stress significantly mediates the impact of prenatal stress on children's sleep quality.
Area of Science:
- Child psychology and developmental health.
- Maternal mental health and its impact on offspring.
- Sleep science and pediatric health outcomes.
Background:
- Childhood sleep quality is crucial for physical, cognitive, and behavioral development.
- Sleep quality in childhood predicts adult sleep patterns.
- Developmental exposures significantly influence childhood sleep.
Purpose of the Study:
- To investigate the association between maternal stress during pregnancy and children's sleep quality.
- To determine if postnatal maternal stress acts as a mediator in this relationship.
Main Methods:
- Utilized data from the Environmental Influences on Child Health Outcomes cohort.
- Measured maternal stress using the Perceived Stress Scale (PSS).
- Assessed child sleep quality via the Child Behavior Checklist (CBCL) and Patient-Reported Outcomes Measurement Information System Sleep Disturbance Parent Proxy short form 4a (PSD4a) at ages 4-8 years.
- Employed linear mixed-effects regression models, adjusting for relevant covariates.
Main Results:
- Prenatal Perceived Stress Scale (PSS) scores were significantly associated with both CBCL and PSD4a sleep outcome scores.
- Postnatal perceived stress mediated a substantial proportion of the total effect of prenatal stress on child sleep outcomes (66.3% for CBCL, 95.9% for PSD4a).
Conclusions:
- Both prenatal and postnatal maternal perceived stress influence early childhood sleep quality.
- Prenatal stress is significantly linked to child sleep problems, with postnatal stress acting as a key mediator.
- Findings highlight the public health importance of addressing maternal psychosocial stress for improving child sleep.
Background:
Childhood sleep quality is associated with physical, cognitive, and behavioral health and predicts later sleep quality; it has many determinants, including developmental exposures.
Objectives:
To examine associations between maternal stress during pregnancy and childhood sleep quality and determine whether postnatal stress mediates the association.
Method:
Data from the Environmental Influences on Child Health Outcomes cohort were used. Perceived Stress Scale (PSS) T-scores were the exposure measure. Outcome measures were preschool Child Behavior Checklist (CBCL) sleep syndrome scale and Patient-Reported Outcomes Measurement Information System Sleep Disturbance Parent Proxy short form 4a (PSD4a) T-scores at ages 4-8 years. Linear mixed-effects regression modeling was performed for each sleep outcome, adjusting for maternal age at delivery and education and child sex, gestational age at birth, and age at outcome ascertainment, with random intercepts for cohorts.
Results:
Prenatal PSS score was associated with both CBCL (B = 0.09, 95% confidence interval [CI]: 0.06, 0.11; p < 0.01) and PSD4a (B = 0.07, 95% CI: 0.03, 0.12; p < 0.01) scores. Postnatal perceived stress mediated a proportion of the total effect of prenatal stress in both CBCL (66.3%) and PSD4a (95.9%) samples.
Conclusions:
Both pre- and postnatal maternal perceived stress appear to influence sleep quality during early life.
Impact:
Prenatal stress significantly associates with child sleep problems and disturbances at ages 4-8 years; postnatal maternal stress is a significant mediator of these associations. Research suggests a range of prenatal affective/distress exposures associated with child sleep problems, but the conclusions remain in doubt due to the mixture of exposures and outcomes employed. Ours is the first US-based effort to explore associations between perceived maternal stress during pregnancy and child sleep problems and disturbance in early and middle childhood. Even a small effect of a prevalent issue like psychosocial stress may have important public health implications at the population level.
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