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Emphasis on continuous infant sleep overnight may be driven by parental concern of risk to child mental health outcomes. The Mercy Pregnancy and Emotional Wellbeing Study (MPEWS) examined whether infant sleep at 6 and 12 months postpartum predicts anxiety disorders at 2–4 years, and whether this is moderated by maternal depression, active physical comforting (APC) or maternal cognitions about infant sleep. Data included 349 women and infants. Infant sleep was measured using the Brief Infant Sleep Questionnaire and child anxiety disorders by the Preschool Age Psychiatric Assessment. The risk of developing generalised anxiety or social phobia disorders at 3–4 years was reduced by 42% (p = 0.001) and 31% (p = 0.001), respectively, for a one standard deviation increase in total sleep at 12 months. No other infant sleep outcomes were associated. Maternal depression, APC and cognitions about infant sleep did not significantly moderate these relationships. Focus may need to be on total infant sleep, rather than when sleep is achieved. Highlights: To assess whether infant sleep outcomes (i.e., frequency of nocturnal wakes; nocturnal wakefulness and total sleep per day) at 6 and 12 months predict early childhood anxiety disorders at 3–4 years of age.Maternally reported infant sleep outcomes were not associated with the risk of developing early childhood anxiety disorders at 3–4 years.It may be total infant sleep, irrespective of when sleep occurs or night waking and, independently, active physical comforting that requires further investigation. [ABSTRACT FROM AUTHOR]

Objective: Perinatal emotional well‐being is more than the presence or absence of depressive and anxiety disorders; it encompasses a wide range of factors that contribute to emotional well‐being. This study compares perinatal well‐being between women living in metropolitan and rural regions. Design: Prospective, longitudinal cohort. Participants/setting: Eight hundred and six women from Victoria and Western Australia recruited before 20 weeks of pregnancy and followed up to 12 months postpartum. Main outcome measures: Rurality was assessed using the Modified Monash Model (MM Model) with 578 in metropolitan cities MM1, 185 in regional and large rural towns MM2‐MM3 and 43 in rural to remote MM4‐MM7. The Structured Clinical Interview for DSM‐IV (SCID‐IV) was administered at recruitment to assess depression, and symptoms of depression and anxiety were measured using the Edinburgh Post‐natal Depression Scale and the State and Trait Anxiety Scale, respectively. Other measures included stressful events, diet, exercise, partner support, parenting and sleep. Results: The prevalence of depressive disorders did not differ across rurality. There was also no difference in breastfeeding cessation, exercise, sleep or partner support. Women living in rural communities and who also had depression reported significantly higher parenting stress than metropolitan women and lower access to parenting activities. Conclusions: Our study suggests while many of the challenges of the perinatal period were shared between women in all areas, there were important differences in parenting stress and access to activities. Furthermore, these findings suggest that guidelines and interventions designed for perinatal mental health should consider rurality. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID‐19 pandemic conditions using a sample from Melbourne, Australia – a city exposed to one of the longest lockdowns world‐wide in response to the pandemic. Methods: This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3–4 years postpartum pre‐COVID pandemic and compared to those followed up during the COVID‐19 pandemic. Results: When compared to mothers followed up at 3–4 years postpartum pre‐pandemic, those followed up during the COVID‐19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMMdifference = 1.72, Bonferroni‐corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni‐corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre‐existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder. Conclusions: Our findings highlight the vulnerability of those with pre‐existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that parenting and early childhood mental health outcomes, at least in the short term, may be resilient. [ABSTRACT FROM AUTHOR]

Background: There have been conflicting findings for severe mental illnesses and the risk for gestational diabetes mellitus (GDM). Outside of pregnancy, both severe mental illnesses and specific antipsychotic medications have been associated with an elevated risk for metabolic disorders, including type 2 diabetes mellitus. Aim: This study examined the risk of developing GDM in relation to mental disorder, psychotropic treatment and comorbid risk factors. Materials and Methods: A retrospective study of 539 pregnant women with mental disorders was carried out. Measures included GDM diagnosis, mental health diagnosis, psychotropic medication, body mass index, age, smoking, alcohol and illicit substance use. Results: This study found that women with psychotic disorders had a significantly elevated risk for GDM (20.9%) compared with women with non‐psychotic severe mental illnesses during pregnancy (P = 0.023), and nearly threefold the expected population rate (8.3%). Furthermore, women using specific antipsychotic agents – risperidone (P = 0.016), clozapine (P < 0.001) and higher‐dose quetiapine (P = 0.029) – also had a higher risk of developing GDM. After adjusting for maternal age and body mass index, women taking these specific agents continued to have a fourfold risk of having GDM compared with women not taking these agents. Smoking, alcohol consumption and illicit drug use were not associated with elevated GDM rate in women with mental disorders. Conclusions: These findings support the need for early screening and closer surveillance of metabolic risk in pregnancy for women with psychotic disorders and those taking specific atypical antipsychotic agents. [ABSTRACT FROM AUTHOR]