Objective: 

Sleep disruption is common among postpartum women and is linked with depression. Child care may alleviate parenting stress and protect new mothers against symptoms of depression.

Methods: 

Mothers from the NURTURE study, a birth cohort of 666 women of full-term infants, completed questionnaires during home visits when their infants were 3, 6, 9, and 12 months old. The Edinburgh Postnatal Depression Scale and the Perceived Stress Scale were used to measure depressive symptoms and stress, respectively. Mothers reported total nightly sleep duration for themselves and their infants, child care arrangements, marital status, and income. We used mixed-effects models adjusting for income, marital status, and child age to examine the indirect effect of infants' sleep on maternal mental health through mothers' sleep and assessed whether patterns differed depending on child care.

Results: 

Decreased maternal sleep mediated the association between infant sleep and maternal mental health. When infants slept 1 hour less than usual, mothers slept 7 fewer minutes (B = 0.19, 95% confidence interval [CI], 0.01 to 0.27) and reported more depressive symptoms (B = −0.27, 95% CI, −0.43 to −0.11) and stress (B = −0.33, 95% CI −0.58 to −0.09). Child care moderated the indirect effect; decreased maternal sleep was not associated with increased depressive symptoms (and was not a mediator) when mothers had child care (indirect effect = −0.001, 95% CI, −0.03 to 0.03).

Conclusion: 

Use of infant child care reduced the link between maternal sleep and depressive symptoms. Regular access to child care may be a method to mitigate feelings of depression for new mothers.

中文翻译：

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使用托儿服务削弱了母亲睡眠减少与抑郁症状增加之间的联系

客观的： 

睡眠中断在产后女性中很常见，并且与抑郁症有关。托儿服务可以减轻育儿压力并保护新妈妈免受抑郁症状的影响。

方法： 

NURTURE 研究是一个由 666 名足月婴儿妇女组成的出生队列，她们在婴儿 3、6、9 和 12 个月大时在家访时填写了问卷。爱丁堡产后抑郁量表和感知压力量表分别用于测量抑郁症状和压力。母亲们报告了自己和婴儿的每晚总睡眠时间、儿童保育安排、婚姻状况和收入。我们使用调整收入、婚姻状况和儿童年龄的混合效应模型来检查婴儿睡眠通过母亲睡眠对母亲心理健康的间接影响，并评估模式是否因儿童保育而异。

结果： 

母亲睡眠减少介导了婴儿睡眠与母亲心理健康之间的关联。当婴儿的睡眠时间比平时少 1 小时时，母亲的睡眠时间会减少 7 分钟（B = 0.19，95% 置信区间 [CI]，0.01 至 0.27），并报告更多的抑郁症状（B = -0.27，95% CI，-0.43 至 - 0.11）和应力（B = -0.33，95% CI -0.58 至 -0.09）。儿童保育调节了间接影响；当母亲照顾孩子时，母亲睡眠减少与抑郁症状增加无关（并且不是中介效应）（间接影响 = -0.001，95% CI，-0.03 至 0.03）。

结论： 

使用婴儿托儿服务减少了母亲睡眠与抑郁症状之间的联系。定期接受托儿服务可能是减轻新妈妈抑郁情绪的一种方法。