Date Available

4-30-2025

Year of Publication

2023

Document Type

Graduate Capstone Project

Degree Name

Master of Public Health (M.P.H.)

College

Public Health

Faculty

Steven Browning and Ketrell McWhorter

Committee Member

Steven Browning

Faculty

Richard Ingram

Faculty

Ketrell McWhorter

Abstract

Objectives: To determine the relationship between maternal depressive symptoms and unsafe infant sleep intention and practices during and after pregnancy.

Methods: This study recruited 100 women from a small clinic in a low-resource community of Santo Domingo, Ecuador from 2018 to 2020. Information on intention to practice safe sleep was collected during the third trimester of pregnancy and safe sleep practices were assessed at 1 month and 6 months postpartum via survey. Depressive symptoms were measured using the Patient Health Questionnaire 2 (PHQ-2). Using log-binomial regression, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) cross-sectionally at each time point.

Results: Pregnant women with depressive symptoms were more likely to report an unsafe position as the position the infant should sleep in (PR=1.12; 95% CI: 0.84 – 1.50) and to intend to put unsafe items in the infant sleeping environment (PR=1.56; 95% CI: 0.67 – 3.63). Mothers with depression were more likely put their infant to bed in an unsafe position at both 1 and 6 months postpartum (PR=1.15; 95% CI: 0.39 – 3.41; PR=1.26, 95% CI: 0.46 – 3.43), respectively. At 1- month postpartum, these mothers also had a higher prevalence of letting their child sleep with unsafe items (PR= 1.61, 95% CI: 0.95 – 2.73), though this relationship attenuated at 6 months (PR 0.87 95% CI: 0.45 – 1.74).

Conclusions: Findings suggest the need for early and comprehensive screening for postpartum depression and early interventions to reinforce safe sleeping practices among mothers who exhibit depressive symptoms to improve the safety of the sleep environment for infants.

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