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Antenatal daytime sleepiness contributes to adverse neuropsychiatric outcomes in offspring

03 Nov 2018

Increased maternal antenatal daytime sleepiness appears to be associated with elevated risk of neuropsychiatric problems and poorer executive function in early childhood, a study reports.

Researchers looked at 111 mother-child dyads. They explored the associations between maternal daytime sleepiness during pregnancy, assessed at 17 and 28 weeks of gestation using the Epworth Sleepiness Scale, and neuropsychiatric and neurocognitive outcomes in offspring. These outcomes were evaluated using mother-rated questionnaires and neuropsychological tests administered at a mean age of 4.3 years.

In multivariable regression models, maternal antenatal daytime sleepiness was associated with the following: increased total problems (unstandardized regression coefficient [B], 0.25), internalizing psychiatric problems (B, 0.25), psychiatric problems and ADHD symptoms (B, 0.27), and poorer executive function particularly in the areas of attention, working memory and inhibitory control (B, −0.39).

The present data support those of previous large-scale studies where the maternal prenatal emotional state was associated with child psychiatric problems, as well as correspond with a recent animal study showing that antenatal circadian rhythm disruption might predict anxiety- and hyperactivity-related behavioural phenotypes in adult mice. [J Am Acad Child Adolesc Psychiatry 2017;56:30-39.e7; Sci Rep 2017;7:3326]

Maternal daytime sleepiness during pregnancy may contribute to the neuropsychological development in children through the epigenetic functional changes in the neurobiological stress system, including hypothalamus-pituitary adrenal axis and related brain areas, maternal inflammatory milieu and autonomic nervous system, researchers explained.

Overall, the results suggest that antenatal sleep problems carry adverse consequences both for the pregnant woman and her offspring, they added. Hence, excessive daytime sleepiness should be considered an important addition to standard antenatal care.

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