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Sleep and stress in mother-toddler dyads living in low-income homes.

ABSTRACT: Optimal sleeping behaviors are critical for overall development, yet some evidence suggests stress and living in a low-income environment are associated with disruptions of sleeping behaviors early in life. In this study, we investigated the association of toddler sleeping behaviors, particularly difficulties initiating and/or maintaining sleep (DIMS), and maternal and toddler prolonged stress using hair cortisol from dyads living in low-income homes. Hair cortisol was mainly sampled at the posterior vertex of mothers and toddlers (age 20-24 months) and analyzed with immunoassay (n = 94). Toddler DIMS were assessed at 15-19 and 27-31 months of age through mother-rated reports using the Tayside Children's Sleep Questionnaire. We found no associations between toddler DIMS and maternal stress. Additionally, early DIMS did not predict toddler stress. However, while controlling for early DIMS and sociodemographic factors, we found that higher toddler stress predicted greater DIMS in later toddlerhood (b = -2.28, SE = 0.98, p = .02, d_s = 0.64). These study findings highlight the importance of understanding the role of early life stress on later sleep patterns.

SUBMITTER: Bates RA

PROVIDER: S-EPMC8225715 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Sleep and stress in mother-toddler dyads living in low-income homes.

Bates Randi A RA Singletary Britt B Yacques Alexandre A Justice Laura L

Developmental psychobiology 20201225 5

Optimal sleeping behaviors are critical for overall development, yet some evidence suggests stress and living in a low-income environment are associated with disruptions of sleeping behaviors early in life. In this study, we investigated the association of toddler sleeping behaviors, particularly difficulties initiating and/or maintaining sleep (DIMS), and maternal and toddler prolonged stress using hair cortisol from dyads living in low-income homes. Hair cortisol was mainly sampled at the post ...[more]

PMID: 33368168

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Project description:BackgroundRectovaginal group B Streptococcus (GBS) colonisation in pregnant individuals at the time of labour is a major risk factor for invasive GBS disease by age 7 days (early-onset disease). We aimed to investigate the prevalence of rectovaginal GBS colonisation at the time of labour among pregnant women and vertical transmission to their newborns across selected low-income and middle-income African and south Asian countries.MethodsThis prospective, observational study was undertaken at 11 maternity and obstetric care facilities based in Ethiopia, Kenya, Mozambique, Nigeria, Mali, South Africa, Bangladesh, India, and Bhutan. HIV-negative pregnant women aged 18-45 years who were in the early stages of labour and at least 37 weeks' gestation were eligible for inclusion. Lower vaginal and rectal swabs and urine were collected from the women, and swabs of the umbilicus, outer ear, axillary fold, rectum, and throat were obtained from their newborns, for GBS culture. Standardised sampling and culture using direct plating and selective media broth for detection of GBS colonisation was undertaken at the sites. Serotyping of GBS isolates was done in South Africa. The primary outcome was the prevalence of rectovaginal GBS among pregnant women, analysed in participants with available data. This study is registered with the South African National Clinical Trials Register, number DOH-27-0418-4989.Findings6922 pregnant women were enrolled from Jan 10, 2016, to Dec 11, 2018, of whom 6514 (94·1%; 759-892 per country) were included in the analysis; data from Bhutan were not included in the study due to issues with specimen collection and processing. Overall, the prevalence of maternal GBS colonisation was 24·1% (95% CI 23·1-25·2; 1572 of 6514); it was highest in Mali (41·1% [37·7-44·6]; 314 of 764) and lowest in Ethiopia (11·6% [9·5-14·1]; 88 of 759). The overall rate of vertical transmission of GBS from women with rectovaginal GBS colonisation was 72·3% (70·0-74·4; 1132 of 1566); it was highest in Mozambique (79·2% [73·3-84·2]; 168 of 212) and lowest in Bangladesh (55·8%, 47·5-63·8; 77 of 138). The five most common GBS colonising serotypes were Ia (37·3% [34·9-39·7]; 586 of 1572), V (28·5% [26·3-30·8]; 448 of 1572), III (25·1% [23·0-27·3]; 394 of 1572), II (9·2% [7·8-10·7]; 144 of 1572), and Ib (6·5% [5·4-7·8]; 102 of 1572). There was geographical variability in serotype proportion distribution; serotype VII was the third most common serotype in India (8·6% [5·3-13·7]; 15 of 174) and serotype VI was mainly identified in Bangladesh (5·8% [3·0-11·0]; eight of 138) and India (5·7% [3·2-10·3]; ten of 174).InterpretationOur study reported a high prevalence of GBS colonisation in most settings, with some geographical variability even within African countries. Our findings suggest that serotypes not included in current multivalent capsular-polysaccharide GBS vaccines prevail in some regions, so vaccine efficacy and post-licensure effectiveness studies should assess the effect of vaccination on maternal GBS colonisation given the potential for replacement by non-vaccine serotypes.FundingBill & Melinda Gates Foundation.

Project description:IntroductionGlobally, children living with HIV continue to lag behind UNAIDS targets for viral suppression (VS). Because studies with linked mother-child data are limited, we describe VS and associated factors among young children in a setting with early infant HIV testing (at birth, age 10 weeks and 6 months) and early protease inhibitor-based first-line antiretroviral therapy (ART).MethodsWe analysed routinely collected mother-child data for children living with HIV born 2018-2022 in Western Cape province, South Africa (followed through mid-2023). We assessed associations between child and maternal viral load (VL) results at 12 and 24 months after child ART start using logistic regression, adjusted for child sex, birthyear, severity of child immunodeficiency at ART start, maternal age and timing of maternal HIV diagnosis.ResultsAmong 2219 children living with HIV; 30% were diagnosed at birth (≤7 days), 41% before age 1 year (8-365 days) and 29% at age >1 year. Overall, 5% (n = 112/2219) of children died, a third of whom had not started ART; 90% of children (n = 1990) started ART, at median age 5 months (IQR 1-16). Median follow-up from ART start was 26 months (IQR 14-40). Among children with available VL at 12 months (n = 853/1582), 24 months (n = 614/1129) and 36 months (n = 350/658) after ART start, 36%, 43% and 48% were virally suppressed, respectively (VL<100 copies/ml). VS among children at 12 and 24 months was more likely if maternal VL was <100 versus ≥100 copies/ml at 12 months (adjusted odds ratio [aOR] = 3.5; 95% CI 1.9-6.5) and 24 months (aOR = 6.1; 95% CI 2.8-13.1) after child ART start. Children with no/mild versus advanced/severe immunodeficiency at ART start were more likely to achieve VS at 12 months (aOR = 2.3; 95% CI 1.3-4.2) but not at 24 months. Eligible children with missing VL at 24 months (39%) were more likely to have gaps in care of >6 months than those with VL≥100 or VL<100 copies/ml (84% vs. 28% vs. 14%, respectively; p<0.001).ConclusionsLess than half of children on ART achieved VS, and children were more likely to achieve VS if their mothers were also virally suppressed. Significant efforts are needed to support mother-child dyads to achieve optimal VS.

Dataset Information

Sleep and stress in mother-toddler dyads living in low-income homes.

Publications

Sleep and stress in mother-toddler dyads living in low-income homes.

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