Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2020

01-12-2020 | Anxiety | Research article

Effects of journal therapy counseling with anxious pregnant women on their infants’ sleep quality: a randomized controlled clinical trial

Authors: Maryam Montazeri, Mojgan Mirghafourvand, Khalil Esmaeilpour, Sakineh Mohammad-Alizadeh-Charandabi, Paria Amiri

Published in: BMC Pediatrics | Issue 1/2020

Login to get access

Abstract

Background

Sleep is especially important for infants, since it stimulates the development of neural connections in their brains. Psychological stress such as anxiety could affect sleep quality. This study investigated the effects of journal therapy counseling sessions on the infants’ sleep quality based on mothers’ perception (primary outcome), maternal anxiety, infants’ anthropometric and developmental parameters, and the frequency of exclusive breastfeeding (secondary outcomes).

Methods

A total of 70 healthy women with gestational age of 28–31 weeks participated in this randomized controlled trial. The participants were randomly allocated into intervention and control groups using randomized block design. Three in-person journal therapy sessions and three telephone counseling sessions (2 between in-person sessions and 1 one month postpartum) were provided to those in the intervention group, while the control group only received routine care. The Infant Sleep Questionnaire (ISQ), Exclusive Breastfeeding Checklist, and Infant Anthropometric Parameters Checklist were completed at two and four months postpartum. The Beck Anxiety Inventory (BAI) was completed during pregnancy, at the end of the intervention, and at two and four months postpartum, and the Ages and Stages Questionnaire (ASQ) was completed at 4 months postpartum. Data were analyzed using chi-square, independent t-test, ANCOVA and repeated measure ANOVA.

Results

There was no significant difference between the two groups in demographic characteristics and baseline anxiety scores. The mean sleep quality score in infants two months of age (MD: -4.2; 95%CI: − 1.1 to − 7.2; P = 0.007) and four months of age (MD: -5.5; 95%CI: − 8.4 to − 2.7; P < 0.001) was significantly lower in the intervention group than that of those in the control group. Based on the repeated measure ANOVA results, the mean postpartum anxiety score of mothers in the intervention group was significantly lower than that of those in the control group (AMD: -7.7; 95%CI: − 5.5 to − 10.1; P < 0.001). There was no significant difference between the two groups regarding other outcomes including the frequency of exclusive breastfeeding, and anthropometric and developmental parameters (P > 0.05).

Conclusion

Journal therapy can decrease mothers’ anxiety and improve the infants’ sleep quality based on their perception. However, further studies are required before drawing any definitive conclusion.

Trial registration number

Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N45. Date of registration: August 11, 2018. URL: https://​en.​irct.​ir/​trial/​33211.
Literature
1.
Rahimi O. The importance of neonatal sleep care in neonatal intensive care unit. Clin Excell. 2014;2(1):83–98.
2.
Chaput J-P, Gray CE, Poitras VJ, Carson V, Gruber R, Birken CS, MacLean JE, Aubert S, Sampson M, Tremblay MS. Systematic review of the relationships between sleep duration and health indicators in the early years (0–4 years). BMC Public Health. 2017;17(5):855.PubMedPubMedCentralCrossRef
3.
Devita M, Peppard PE, Mesas AE, Mondini S, Rusconi ML, Barnet JH, Hagen EW. Associations between the apnea-hypopnea index during REM and NREM sleep and cognitive functioning in a cohort of middle-aged adults. J Clin Sleep Med. 2019;15(7):965–71.PubMedCrossRef
4.
5.
Werth J, Atallah L, Andriessen P, Long X, Zwartkruis-Pelgrim E, Aarts RM. Unobtrusive sleep state measurements in preterm infants–a review. Sleep Med Rev. 2017;32:109–22.PubMedCrossRef
6.
Iemura A, Iwasaki M, Yamakawa N, Tomiwa K, Anji Y, Sakakihara Y, Kakuma T, Nagamitsu S, Matsuishi T. Influence of sleep-onset time on the development of 18-month-old infants: Japan Children’s cohort study. Brain and Development. 2016;38(4):364–72.PubMedCrossRef
7.
Hysing M, Harvey AG, Torgersen L, Ystrom E, Reichborn-Kjennerud T, Sivertsen B. Trajectories and predictors of nocturnal awakenings and sleep duration in infants. J Dev Behav Pediatr. 2014;35(5):309–16.PubMedCrossRef
8.
9.
10.
Hoevenaar-Blom MP, Spijkerman AM, Kromhout D, van den Berg JF, Verschuren W. Sleep duration and sleep quality in relation to 12-year cardiovascular disease incidence: the MORGEN study. Sleep. 2011;34(11):1487–92.PubMedPubMedCentralCrossRef
11.
Dewald JF, Meijer AM, Oort FJ, Kerkhof GA, Bögels SM. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: a meta-analytic review. Sleep Med Rev. 2010;14(3):179–89.PubMedCrossRef
12.
Arasteh M, Yousefi F, Sharifi Z. Investigation of sleep quality and its influencing factors in patients admitted to the gynecology and general surgery of besat hospital in Sanandaj. Med J Mashhad Univ Med Sci. 2014;57(6):762–9.
13.
Tikotzky L, De Marcas G, Har-Toov J, Dollberg S, Bar-Haim Y, Sadeh A. Sleep and physical growth in infants during the first 6 months. J Sleep Res. 2010;19(1-Part-I):103–10.PubMedCrossRef
14.
Goldberg WA, Lucas-Thompson RG, Germo GR, Keller MA, Davis EP, Sandman CA. Eye of the beholder? Maternal mental health and the quality of infant sleep. Soc Sci Med. 2013;79:101–8.PubMedCrossRef
15.
Haghighat M, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Malakouti J, Erfani M. The effect of spiritual counseling on stress and anxiety in pregnancy: A randomized controlled clinical trial. Iran Red Crescent Med J. 2018;20(4):e64094.
16.
Nath A, Venkatesh S, Balan S, Metgud CS, Krishna M, Murthy GV. The prevalence and determinants of pregnancy-related anxiety amongst pregnant women at less than 24 weeks of pregnancy in Bangalore, Southern India. Int J Women's Health. 2019;11:241–8.CrossRef
17.
Bazr Afshan M, Mahmoodi RA. The relationship between women's anxiety during pregnancy and labor outcomes in Larestan hospitals. Mandish. 2009;1(1):1–12.
18.
Hasanjanzadeh P, Faramarzi M. Relationship between maternal general and specific-pregnancy stress, anxiety, and depression symptoms and pregnancy outcome. J Clin Diagn Res. 2017;11(4):VC04.PubMedPubMedCentral
19.
Rahimi f, Ahmadi m, Rosta f, Alavi majd h, Valiani m. Effect of relaxation training on pregnancy anxiety in high risk women. J Saf Promot Inj Prevent 2014; 2(3):180–189.
20.
Glover V. Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol. 2014;28(1):25–35.PubMedCrossRef
21.
22.
Maryam GA, Shohre GS, Javad K. Effectiveness of hardiness training on anxiety and quality of life of pregnancy women. Procedia Soc Behav Sci. 2013;84:1785–9.CrossRef
23.
Shahhosseini Z, Pourasghar M, Khalilian A, Salehi F. A review of the effects of anxiety during pregnancy on children’s health. Mater Sociomed. 2015;27(3):200.PubMedPubMedCentralCrossRef
24.
Baird J, Hill CM, Kendrick T, Inskip HM, Group SS. Infant sleep disturbance is associated with preconceptional psychological distress: findings from the Southampton Women's survey. Sleep. 2009;32(4):566–8.PubMedPubMedCentralCrossRef
25.
Sorondo BM, Reeb-Sutherland BC. Associations between infant temperament, maternal stress, and infants’ sleep across the first year of life. Infant Behav Dev. 2015;39:131–5.PubMedPubMedCentralCrossRef
26.
Petzoldt J, Wittchen HU, Einsle F, Martini J. Maternal anxiety versus depressive disorders: specific relations to infants' crying, feeding and sleeping problems. Child Care Health Dev. 2016;42(2):231–45.PubMedCrossRef
27.
Latifi M. The effect of aromatherapy with orange essential oils on sleep quality in the school-age children whit ALL. Complement Med J Arak Univ Med Sci. 2015;5(1):1113–22.
28.
Hall WA, Moynihan M, Bhagat R, Wooldridge J. Relationships between parental sleep quality, fatigue, cognitions about infant sleep, and parental depression pre and post-intervention for infant behavioral sleep problems. BMC Pregnancy Childbirth. 2017;17(1):104.PubMedPubMedCentralCrossRef
29.
Watts S. The prevention of infant sleep disturbance: a universal approach. RMIT University 2015.
30.
Crits-Christoph P, Newman MG, Rickels K, Gallop R, Gibbons MBC, Hamilton JL, Ring-Kurtz S, Pastva AM. Combined medication and cognitive therapy for generalized anxiety disorder. J Anxiety Disord. 2011;25(8):1087–94.PubMedPubMedCentralCrossRef
31.
Reinhold M, Bürkner PC, Holling H. Effects of expressive writing on depressive symptoms—a meta-analysis. Clin Psychol Sci Pract. 2018;25(1):e12224.CrossRef
32.
Moradmand M, Khanbani M. Efficacy of written emotional disclosure on self-efficacy and affective control in student with anxiety. J Appl Psychol. 2016;1(37):21–37.
33.
Nagel D, Anthony K. Writing therapy using new technologies—the art of blogging. J Poet Ther. 2009;22(1):41–5.CrossRef
34.
Van Emmerik AA, Reijntjes A, Kamphuis JH. Writing therapy for posttraumatic stress: a meta-analysis. Psychother Psychosom. 2013;82(2):82–8.PubMedCrossRef
35.
Cronin A, Halligan SL, Murray L. Maternal psychosocial adversity and the longitudinal development of infant sleep. Infancy. 2008;13(5):469–95.CrossRef
36.
Beck AT, Steer RA. Manual for the Beck anxiety inventory. San Antonio, TX: Psychological Corporation; 1990.
37.
Teti DM, Kim B-R, Mayer G, Countermine M. Maternal emotional availability at bedtime predicts infant sleep quality. J Fam Psychol. 2010;24(3):307.PubMedCrossRef
38.
Mohseniyan E. The role of mood, sleep patterns, and mother's perception of sleeping, in toddlers' sleep problems. Mashad-Iran: Ferdowsi University of Mashhad; 2012.
39.
Motlagh M. Executive Order of Developmental Screening Tool ASQII. In: Ministry of Health and Medical Education DoH, Population Health, Family and Schools. Tehran-Iran: Children's Health Department; 2011.
40.
Vameghi R, Sajedi F, Mojembari AK, Habiollahi A, Lornezhad HR, Delavar B. Cross-cultural adaptation, validation and standardization of Ages and Stages Questionnaire (ASQ) in Iranian children. Iran J Public Health. 2013;42(5):522.PubMedPubMedCentral
41.
Sehhatie FS, Mirghafourvand M, Havizari S. Effect of prenatal counseling on exclusive breastfeeding frequency and infant weight gain in mothers with previous unsuccessful breastfeeding: a randomized controlled clinical trial. J Matern Fetal Neo Med. 2019:1–8. https://​doi.​org/​10.​1080/​14767058.​2019.​1579191. [Epub ahead of print].
42.
Hasanzadeh P, Fallahi Khoshknab M, Norozi K. Impacts of journaling on anxiety and stress in multiple sclerosis patients. Complement Med J Fac Nurs Midwifery. 2012;2(2):183–93.
43.
Niles AN, Haltom KEB, Mulvenna CM, Lieberman MD, Stanton AL. Randomized controlled trial of expressive writing for psychological and physical health: the moderating role of emotional expressivity. Anxiety Stress Coping. 2014;27(1):1–17.PubMedCrossRef
44.
Kaplan H, Saduk B. Synopsis of clinical psychiatry. Translated by Farzin Rezei. Tehran: Arjmand Publication; 2015.
45.
Burdayron R, Laganiere C, Butler B, Dubois-Comtois K, Beliveau M-J, Pennestri M-H. Maternal anxiety and its association with perceptions of infant sleep-related behaviours. Sleep. 2019;42(Supplement_1):A312–3.CrossRef
46.
Ruscio AM, Borkovec T. Experience and appraisal of worry among high worriers with and without generalized anxiety disorder. Behav Res Ther. 2004;42(12):1469–82.PubMedCrossRef
47.
Diego MA, Jones NA, Field T, Hernandez-Reif M, Schanberg S, Kuhn C, Gonzalez-Garcia A. Maternal psychological distress, prenatal cortisol, and fetal weight. Psychosom Med. 2006;68(5):747–53.PubMedCrossRef
48.
Alipour Z, Hajizadeh E, Lamyian M. Anxiety during pregnancy: a risk factor for neonatal physical outcome? J Urmia Nurs Midwifery Fac. 2011;9(1):30–8.
49.
Broekman BF, Chan YH, Chong YS, Kwek K, Sung SC, Haley CL, Chen H, Chee C, Rifkin-Graboi A, Gluckman PD. The influence of anxiety and depressive symptoms during pregnancy on birth size. Paediatr Perinat Epidemiol. 2014;28(2):116–26.PubMedCrossRef
50.
Rasouli P, Shobeiri F, Cheraghi F, Rasouli R. GhanbariV. Study of the relationship of anxiety and depression in third trimester pregnancy on growth index of neonates and preterm delivery. Iran J Pediatr. 2016;2(4):1–9.
51.
Camerota M, Tully KP, Grimes M, Gueron-Sela N, Propper CB. Assessment of infant sleep: how well do multiple methods compare? Sleep. 2018;41(10):zsy146.PubMedCentralCrossRef
52.
Morrell JMB. The infant sleep questionnaire: a new tool to assess infant sleep problems for clinical and research purposes. Child Psychol Psychiatry Rev. 1999;4(1):20–6.CrossRef
Metadata
Title
Effects of journal therapy counseling with anxious pregnant women on their infants’ sleep quality: a randomized controlled clinical trial
Authors
Maryam Montazeri
Mojgan Mirghafourvand
Khalil Esmaeilpour
Sakineh Mohammad-Alizadeh-Charandabi
Paria Amiri
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Anxiety
Published in
BMC Pediatrics / Issue 1/2020
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-020-02132-7

Other articles of this Issue 1/2020

BMC Pediatrics 1/2020 Go to the issue

Research article

Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study

Study protocol

Study protocol: parents as pain management in Swedish neonatal care – SWEpap, a multi-center randomized controlled trial

Research article

“The cord is the child”: meanings and practices related to umbilical cord care in Central Uganda

Research article

Risk factors for low cardiac output syndrome in children with congenital heart disease undergoing cardiac surgery: a retrospective cohort study

Technical advance

Reliability of accelerometric assessment of balance in children aged 6–12 years

Case report

Clinical, biochemical and metabolic characterization of patients with short-chain enoyl-CoA hydratase(ECHS1) deficiency: two case reports and the review of the literature