Prenatal stress and infant sleep: The role of maternal emotional distress and sensitive behavior.

The association between prenatal stress factors and infant sleep has been examined in the literature, however, the mechanisms explaining this association remain unclear. The present study examined the indirect association between prenatal stress and infant sleep problems via maternal emotional distress and maternal sensitivity in distress-eliciting context in a three-wave longitudinal study that followed 299 mothers from pregnancy until the infants were 6 months old. Expectant mothers reported demographics, prenatal stress (i.e., stressful life events, neighborhood violence, income) and emotional distress (i.e., depressive symptoms, trait anxiety, emotion regulation difficulties, and personality characteristics) Prior to the 2-month laboratory visit, mothers reported their depressive symptoms and state anxiety. During the 2- and 6-month laboratory visits, maternal sensitivity in distress-eliciting context was assessed during the still-face episode of the still-face paradigm. Mothers reported infant sleep problems at 6 months. Consistent with hypotheses, prenatal stress predicted higher perinatal emotional distress which in turn was significantly associated with lower maternal sensitivity. Further, maternal sensitivity was significantly associated with fewer infant sleep problems. The indirect pathway from prenatal stress to infant sleep problems via elevated maternal emotional distress and compromised maternal sensitivity was statistically significant. The findings affirm the need for policies and interventions to better support mothers exposed to prenatal stress and/or experiencing emotional distress to ensure optimal infant sleep outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).