Late preterm as an often-overlooked group: the interplay of sleep, maternal mental health and sleep knowledge

Background Late preterm infants (LPT) are often overlooked despite representing a significant proportion of preterm births. This study explores the sleep characteristics of LPT infants aged 3-6 months compared with their term-born peers and investigates the relationship between infant sleep patterns, maternal mental health and maternal knowledge about infant sleep. Methods A total of 84 infant-mother dyads were included. Infant sleep characteristics were assessed using the Brief Infant Sleep Questionnaire (BISQ) with an additional norm-referenced scoring system to evaluate age-based sleep parameters. Maternal mental health was evaluated through the Depression, Anxiety and Stress Scale (DASS-21) and maternal knowledge of infant sleep was measured using a questionnaire based on the American Academy of Pediatrics' recommendations. Results Sleep patterns between LPT and term infants were comparable, including nocturnal sleep duration (p=0.75) and nocturnal awakenings (p=0.33). However, maternal perceptions of sleep quality significantly differed, with LPT infants scoring higher on the Parent Perception subscale of the BISQ (median: 82.5 vs 70, p=0.04). Maternal DASS scores were negatively correlated with BISQ subscales in LPT infants. Anxiety scores were significantly associated with Parent Perception (r=-0.413, p<0.01) and total BISQ scores (r=-0.418, p<0.01). Depression was linked to lower Parent Perception (r=-0.346, p=0.03) and total BISQ scores (r=-0.319, p=0.04), while stress was associated with lower Parent Perception scores (p=0.03). In term infants, maternal knowledge of infant sleep was significantly higher in good sleepers (p=0.03), while maternal DASS scores showed no significant associations with sleep outcomes. Conclusions Infant sleep should be considered within the maternal-infant dyad, with maternal factors playing a crucial role in shaping sleep outcomes, differing between LPT and term infants. The interplay between maternal mental health, parental sleep knowledge and sleep expectations warrants further investigation. . Author(s) (or their employer(s)) 2025.