1Nursing Department, Sekolah Tinggi Ilmu Kesehatan Nani Hasanuddin, Makassar South Sulawesi Indonesia; 2Center for Biomedical Research, Research Organization for Health, National Research and Innovation Agency (BRIN), Cibinong Science Center, Cibinong-Bogor, West Java, Indonesia; 3Sekolah Tinggi Ilmu Kesehatan, Makassar, Indonesia

We have read the article by Wang et, al entitled Correlation Between Maternal Anxiety During Mid-Pregnancy and Subsequent Infant Sleep Problems: A Cross-Sectional Study from 2015 to 2016.1 We congratulate the authors for this important contribution to maternal mental health conditions especially during childbearing years.2 Hence, we aim to offer our perspectives on this study and contribute insights to further develop and expand this research if there is an intention to pursue it in the future. Maternal anxiety are the common mental disorder3 faced by a mother during pregnancy and yet impaired the birth outcome. According to a review anxiety often comes and derived from many circumstances between the internal environment and the psychological changes in mothers.4

This study’s technique indicated an effective effort in evaluating the association between maternal anxiety during mid-pregnancy and new-born sleep conditions. One of the study’s main strengths was its meticulous attention to detail in data gathering and quality control processes. The use of validated instruments, such as the Self-rating Anxiety Scale (SAS) to assess maternal anxiety and standardized criteria to determine infant sleep parameters, ensured the findings’ reliability and validity, though other validated measurement tool options could be considered.5

The study’s findings reveal the link between maternal anxiety and infant sleep patterns, emphasizing a crucial aspect of perinatal health. Significant correlations between maternal anxiety during mid-pregnancy and infant sleep states emphasize maternal psychological well-being’s potential impact on early childhood development. These results carry implications for clinical practice, emphasizing the necessity for interventions to support maternal mental health during pregnancy and improving parent knowledge6 in infants healthy sleep habits. While the findings of this study are commendable, there are opportunities for further refinement and expansion in the future. For example, using a longitudinal design7 with real-time data collection would provide more accurate insight into the dynamic relationship between maternal anxiety and infant sleep patterns over time, thus providing a stronger understanding of causality. For future research, we recommend videosomnography for night waking behaviour, actigraphy for sleep duration, and sleep diaries for parental perception.8 This combined approach not only allows validation of findings across different measurement modalities, but also provides deeper insights into the contextual factors that influence infant sleep. By adopting a multi-method approach, researchers can overcome the limitations of individual measurements and contribute to a more nuanced understanding of infant sleep development and its implications for child health and well-being. In addition, exploring additional factors such as maternal mental health history, social support networks, and infant temperament may enrich the analysis and provide a more comprehensive picture of the determinants of infant sleep behaviour.

Overall, this study contributes significantly to the prenatal health and child sleep knowledge. The authors have contributed significantly to our understanding of the complex relationships between maternal mental health and baby development by addressing crucial research topics using rigorous methods and providing relevant insights for clinical practice. This study emphasizes the need for a comprehensive approach to mother and child health services.

The authors report no conflicts of interest in this communication.

1. Wang S, Cai Z, Gao G, Yan S. Correlation Between Maternal Anxiety During Mid-Pregnancy and Subsequent Infant Sleep Issues: a Cross-Sectional Study from 2015 to 2016. Int J Gen Med. 2024;17:623–633. doi:10.2147/IJGM.S445604

2. Yang K, Wu J, Chen X. Risk factors of perinatal depression in women: a systematic review and meta-analysis. BMC Psychiatry. 2022;22(1):63. doi:10.1186/s12888-021-03684-3

3. Misgana T, Gebremichael B, Tesfaye D, et al. The Impact of Maternal Common Mental Disorders on Exclusive Breastfeeding in Eastern Ethiopia: a Prospective Cohort Study. Nutr Diet Suppl. 2024;16:15–26. doi:10.2147/NDS.S449436

4. Mahini E, Hakimi S, Shahrokhi H, et al. Evaluation of factors related to maternal anxiety during pregnancy among women referred to Tabriz primary care centers. BMC Psychiatry. 2023;23(1):329. doi:10.1186/s12888-023-04823-8

5. Sinesi A, Maxwell M, O’Carroll R, Cheyne H. Anxiety scales used in pregnancy: systematic review. BJPsych Open. 2019;5(1):e5. doi:10.1192/bjo.2018.75

6. Li D. Characterization of Parental Knowledge on Early Child Sleep and Association with Child Sleep Quality: a Cross-Sectional Pilot Study in Chongqing, China. Risk Manag Healthc Policy. 2023;16:851–864. doi:10.2147/RMHP.S408428

7. Henderson JM, Blampied NM, France KG. Longitudinal Study of Infant Sleep Development: early Predictors of Sleep Regulation Across the First Year. Nat Sci Sleep. 2020;12:949–957. doi:10.2147/NSS.S240075

8. 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). doi:10.1093/sleep/zsy146