Infant outcomes following treatment of antenatal depression: Findings from a pilot randomized controlled trial

•Antenatal depression is associated with increased risk of disturbed infant sleep.•This is the first trial of CBT for antenatal depression to examine infant outcomes.•Improvement in depression is associated with easier temperament in infants.•Improvement in depression is associated with shorter sleep duration in infants.•The findings are more pronounced in the group receiving CBT.

IntroductionMaternal antenatal depression is associated with an increased risk of emotional and behavioural problems in children. More recently antenatal depression has been associated with shorter sleep duration, higher number of awakenings and sleep problems in infants. Examining the effect of treatment of depression on child development is the next step in unravelling the complex association between antenatal depression and offspring development.MethodsWe used data from a pilot RCT of women with antenatal depression who received either Cognitive Behavioural Therapy (CBT) or Treatment as Usual (TAU), to examine infant sleep duration and temperament two months postpartum. Data was available for n=14 in the CBT group and n=11 in the TAU group.ResultsNo differences by treatment arm were evident. Improvement in depression scores during pregnancy was associated with easier temperament (β=−.45, p=.024) and shorter nocturnal sleep duration (β=−.58, p=.003). The findings were more pronounced in the CBT group compared to the TAU group.LimitationsThis was a pilot RCT and as such the sample size was small and there was some loss to follow up between the baseline and postnatal assessment.ConclusionImprovement in antenatal depressive symptoms may have beneficial effects for the infant; whether these are directly through effects on foetal development or indirectly through changes in the postnatal mother-infant relationship remains to be determined.