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Profiles and Predictors of Infant Sleep Problems Across the First Year

Cook, Fallon PhD*; Conway, Laura PhD*; Gartland, Deirdre DPsych*; Giallo, Rebecca PhD*,†,‡; Keys, Elizabeth PhD§; Brown, Stephanie PhD*,‖

Journal of Developmental & Behavioral Pediatrics: September 25, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/DBP.0000000000000733
Original Article: PDF Only

Objective: To identify profiles and predictors of maternal-reported infant sleep problems across the first postnatal year.

Methods: Survey data examining maternal mental and physical health, intimate partner violence (IPV), and infant sleep problems and night waking were gathered from a cohort of 1,460 nulliparous women at 15 weeks' gestation and when their infants were 3, 6, 9, and 12 months old.

Results: Latent class analysis revealed 5 profiles of infant sleep problems, including those who had few problems (24.7%), persistent moderate problems (27.3%), increased problems at 6 months (10.8%), increased problems at 9 months (17.8%), and persistent severe problems (19.4%). Persistent severe infant sleep problems were associated with prepartum and postpartum maternal depression (adjusted odds ratio [AOR] 2.13, 95% confidence interval [CI] 1.35–3.34, p < 0.01; AOR 2.52, 95% CI 1.64–3.87, p < 0.001, respectively), poorer prepartum and postpartum perception of health (adjusted mean difference [AMD] 23.48, 95% CI 24.9 to 22.1, p < 0.01; AMD 23.78, 95% CI 25.2 to 22.4, p < 0.001, respectively), increased postpartum anxiety (AOR 2.22, 95% CI 1.26–3.90, p < 0.01), and increased prevalence of IPV in the first year postpartum (AOR 1.86, 95% CI 1.20–2.87, p < 0.01).

Conclusion: Poorer prepartum and postpartum maternal mental and physical health, and IPV, were associated with maternal report of persistent severe infant sleep problems. Women experiencing prenatal physical and mental health difficulties may benefit from advice on managing infant sleep and settling. Health professionals working with unsettled infants must be equipped to enquire about and respond appropriately to disclosures of IPV.

This article has supplementary material on the web site:

*Murdoch Children's Research Institute, Intergenerational Health Research Group, Melbourne, Australia;

Department of Pediatrics, University of Melbourne, Melbourne, Australia;

School of Psychology and Public Health, LaTrobe University, Bundoora, Australia;

§Faculty of Nursing, University of Calgary, Calgary, Canada;

Department of General Practice and Department of Pediatrics, University of Melbourne, Melbourne, Australia.

Address for reprints: Fallon Cook, PhD, Murdoch Children's Research Institute, Intergenerational Health Research Group, Flemington Rd, Parkville, Victoria 3052, Australia; e-mail:

This study was supported by project grants #191222, #433006, and #1048829 from the Australian National Health and Medical Research Council (NHMRC) and small grants from ANZ Medical Research Fund and Rotary Health. F. Cook and L. Conway were supported by Melbourne Children's LifeCourse postdoctoral fellowships, funded by Royal Children's Hospital Foundation grant (#2018-984). S. Brown was supported by a NHMRC Research Fellowship # 1103976, and R. Giallo was supported by a NHMRC Career Development Fellowship #1109889. Research at the Murdoch Children's Research Institute is supported by the Victorian Government's Operational Infrastructure Support Program. The funding organizations are independent of all researchers and had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the decision to submit the article for publication or in the preparation, review, or approval of the article.

Disclosure: The authors declare no conflict of interest.

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F. Cook developed the article proposal, performed data analysis, and wrote the article. L. Conway contributed to development of the article proposal, provided feedback, and made edits to the article. R. Giallo and E. Keys assisted with data analysis, provided feedback, and made edits to the article. D. Gartland contributed to the design and execution of the cohort study, provided feedback, and made edits to the article. S. Brown conceptualized the cohort study, wrote the original study protocol, and has overseen the conduct of the study since its inception. In addition, S. Brown provided feedback on previous versions of the article and approved the final version.

Received February 26, 2019

Accepted August 12, 2019

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