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Associations between childhood maltreatment, poor sleep, and prenatal distress in pregnant adolescents

Published online by Cambridge University Press:  08 February 2021

Sophie Foss*
Affiliation:
Department of Psychiatry, Columbia University Medical Center, New York, NY, USA Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Hanna C. Gustafsson
Affiliation:
Department of Psychiatry, Columbia University Medical Center, New York, NY, USA Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
Obianuju O. Berry
Affiliation:
Department of Psychiatry, Columbia University Medical Center, New York, NY, USA New York State Psychiatric Institute, New York, NY, USA
Alison E. Hipwell
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Elizabeth A. Werner
Affiliation:
Department of Ob/Gyn, Columbia University Medical Center, New York, NY, USA
Bradley S. Peterson
Affiliation:
Department of Psychiatry, Children's Hospital Los Angeles, Los Angeles, CA, USA
Catherine Monk
Affiliation:
New York State Psychiatric Institute, New York, NY, USA Department of Ob/Gyn, Columbia University Medical Center, New York, NY, USA
*
Author for Correspondence: Sophie Foss, Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, 300 Longwood Avenue BCH 3222, Boston, MA 02115, USA; Email: sophie.foss@childrens.harvard.edu

Abstract

Childhood maltreatment (CM) is a known risk factor for adolescent pregnancy. Sleep disturbances and psychological distress, both common negative sequelae of CM, often co-occur during pregnancy, although directionality remains unclear. Furthermore, little is known about how CM affects sleep–distress associations during pregnancy. In pregnant adolescents, we examined: (a) whether there are significant predictive associations from CM to sleep quality and distress and (b) bidirectional influences of distress and sleep quality. Healthy pregnant adolescents (n = 204) were recruited before or during the 2nd trimester. CM was assessed at enrollment; sleep quality and distress were assessed in the 2nd and 3rd trimesters. Hypotheses were tested using path analysis. Findings revealed that CM was associated with worse 2nd trimester sleep quality and distress (β = .19, p < .05 for sleep; β = .30, p < .001 for distress). Higher levels of 2nd trimester distress were associated with lower 3rd trimester sleep quality (β = .19, p < .05). Findings provide novel information about (a) associations from CM to prenatal mood and sleep in pregnant adolescents, and (b) sleep–distress directionality over the course of pregnancy. These results have implications for better understanding the ways in which CM potentially exerts influences later in life, and for targeting interventions to address physical and mental health during pregnancy.

Type
Regular Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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