Racial/ethnic disparities in sleep in mothers and infants during the Covid-19 pandemic

Study Objectives: To quantify the association between race/ethnicity and maternal and infant self-reported sleep health at 4 months, exploring the role of maternal depression, stress and symptoms of trauma related to the COVID-19 pandemic as potential mediators. Methods: Participants were recruited as part of the COVID-19 Mother Baby Outcomes (COMBO) cohort at Columbia University (N=71 non-Hispanic White, N=14 African American (AA), N=113 Hispanic, N=40 other/declined). Data on infant sleep were collected at 4 months postpartum. A subset of 149 women also completed questionnaires assessing maternal mental health and sleep. Multivariable regressions were used to separately estimate associations of race/ethnicity and mental health with multiple sleep domains for infants and mothers adjusting for individual-level covariates. Results: Compared to non-Hispanic White, Hispanic infants slept less at night ({beta}=-101.7{+/-}17.6, p<0.0001) and AA and Hispanic infants went to bed later (respectively {beta} =1.9{+/-}0.6, p<0.0001, {beta}=1.7{+/-}0.3, p<0.0001). Hispanic mothers were less likely to perceive infant sleep as a problem ({beta}=1.0{+/-}0.3, p=0.006). Compared to non-Hispanic White mothers, Hispanic mothers reported worse maternal sleep latency ({beta}=1.2{+/-}0.4, p=0.002), and efficiency ({beta}=0.8{+/-}0.4, p=0.03), but better subjective sleep quality ({beta}=-0.7{+/-}0.4, p=0.05), and less daytime dysfunction ({beta}=-0.8{+/-}0.4, p=0.04). Maternal mental health scores were statistically significant predictors of multiple domains of maternal sleep but did not mediate the association between race/ethnicity and sleep. Conclusions: Racial/ethnic disparities in maternal and infant sleep are observable at 4 months post-partum. Maternal stress, depression and symptoms of trauma related to the COVID-19 pandemic did not mediate these associations.