Sleep patterns and psychosocial health of parents of preterm and full-born infants: a prospective, comparative, longitudinal feasibility study

Fathers' sleep in the first 24 months postpartum: A systematic review and meta-analysis of global data

Maternal sleep is significantly disrupted in the postpartum period, but changes in paternal sleep are less established. Here, we systematically review and meta-analyze available data on paternal sleep in the first 24months post birth, including self-report and objectively measured sleep outcomes. Scopus, PsycINFO, and PubMed were searched for original research articles published until end August 2024. We included studies reporting on quantitative summaries of sleep outcomes and data were pooled using random-effects models primarily. We included 47 studies from 17 countries (N=9684) with most data coming from fathers in North America (K=26), and reporting on a diverse range of sleep outcomes. Most data were available for sleep duration (398.29 minutes; 95% CIs 381.43-415.88), night awakenings (1.14; 95% CIs 1.12-1.16), and wake after sleep onset (36.57 minutes; 95% CIs 20.83-64.20). There was high heterogeneity across these three measures (I2 values >95%). While there were a small number of studies using the Pittsburgh Sleep Quality Index, our pooled estimate suggested poor sleep in fathers (5.93, 95% CIs 4.75-7.41, I2=91%). Overall, we found some evidence for sleep in few fathers being below the recommended levels, but the extent of any paternal deficit depended on the sleep measure. The US-centric dataset limits our understanding of fathers' sleep experiences postnatally, particularly considering the large relative differences between paternity leave access in the United States vs. other countries.

Does preterm birth increase the initiation of antidepressant use during the postpartum? A population-based investigation

Background

Preterm birth may affect maternal mental health. We explored the relationship between preterm birth and the risk of initiating antidepressant use during the year after birth.

Methods

We conducted a population-based investigation using regional healthcare utilization databases. The exposure considered was preterm birth. The outcome was having at least one prescription for antidepressant medications during the year after birth. We used a log-binomial regression model including terms for maternal age at birth, nationality, educational level, parity, modality of conception, modality of delivery, use of other psychotropic drugs, and diabetes to estimate relative risk (RR) and 95% confidence intervals (CI) for the association between preterm birth and the initiation of antidepressant use. In addition, the absolute risk differences (ARD) were also computed according to the timing of birth.

Results

The cohort included 727,701 deliveries between 2010 and 2020 in Lombardy, Northern Italy. Out of these, 6,522 (0.9%) women had at least one prescription for antidepressant drugs during the year after birth. Preterm births were related to a 38% increased risk of initiation of antidepressant use during the year after birth (adjusted RR = 1.38; 95% CI: 1.25-1.52) for moderate to late preterm and to 83% (adjusted RR = 1.83; 95% CI: 1.46-2.28) for extremely and very preterm. Excluding women with only one antidepressant prescription, the association was consistent (adjusted RR = 1.41, 95%CI: 1.23-1.61 for moderate to late preterm and adjusted RR = 1.81, 95% CI: 1.31-2.49 for extremely and very preterm). Also, excluding women who used other psychotropics, the association remained consistent (adjusted RR = 1.39, 95%CI: 1.26-1.54 and adjusted RR = 1.91, 95% CI: 1.53-2.38, respectively for moderate to late and extremely and very preterm).

Conclusion

Women who delivered preterm may have an excess risk of initiation of antidepressant consumption during the first year after birth.