Implications of childhood adversity for women's perinatal sleep quality and depressive symptoms over time: A serial mediation model.

This study sought to examine the effects of childhood adversity on the longitudinal associations between perinatal sleep quality and depressive symptoms, and to determine the prospective associations between these constructs over time. A cross-lagged autoregressive model was used to examine the longitudinal association between sleep quality and depressive symptoms at four points during the perinatal period: 18 and 32 weeks of pregnancy, and 6 and 12 weeks postpartum. Longitudinal mediation models were used to examine whether sleep quality or depressive symptoms mediated the effects of childhood adversity on these symptoms. Most participants (86%) reported poor sleep quality during pregnancy. Significant cross-lagged effects of depressive symptoms on subsequent sleep quality were observed during pregnancy and postpartum. Depressive symptoms significantly mediated the effects of childhood trauma on sleep quality during pregnancy, but sleep quality did not significantly mediate the effects of childhood trauma on depressive symptoms. While sleep quality and depressive symptoms tend to co-occur, our analyses indicate that perinatal depressive symptoms work as the primary driver of sleep quality over time. Childhood adversity may have long-reaching effects in women as it was associated with more depressive symptoms in the perinatal period, which in turn appeared to undermine sleep quality.

Individual differences in processing speed and curiosity explain infant habituation and dishabituation performance.

Habituation and dishabituation are the most prevalent measures of infant cognitive functioning, and they have reliably been shown to predict later cognitive outcomes. Yet, the exact mechanisms underlying infant habituation and dishabituation are still unclear. To investigate them, we tested 106 8-month-old infants on a classic habituation task and a novel visual learning task. We used a hierarchical Bayesian model to identify individual differences in sustained attention, learning performance, processing speed and curiosity from the visual learning task. These factors were then related to habituation and dishabituation. We found that habituation time was related to individual differences in processing speed, while dishabituation was related to curiosity, but only for infants who did not habituate. These results offer novel insights in the mechanisms underlying habituation and serve as proof of concept for hierarchical models as an effective tool to measure individual differences in infant cognitive functioning. RESEARCH HIGHLIGHTS: We used a hierarchical Bayesian model to measure individual differences in infants' processing speed, learning performance, sustained attention, and curiosity. Faster processing speed was related to shorter habituation time. High curiosity was related to stronger dishabituation responses, but only for infants who did not habituate.

Effects of daily full-term infant skin-to-skin contact on behavior and cognition at age three - secondary outcomes of a randomized controlled trial.

BACKGROUND: Daily skin-to-skin contact (SSC) during early infancy fosters the long-term development of children born preterm. This is the first randomized controlled trial assessing the potential beneficial effects of daily SSC on executive functioning and socio-emotional behavior of children born full-term. Whether children of mothers who experienced prenatal stress and anxiety benefitted more from SSC was also explored. METHODS: Pregnant women (N = 116) were randomly assigned to a SSC or care-as-usual (CAU) condition. Women in the SSC condition were instructed to perform one hour of SSC daily from birth until postnatal week five. Prenatal stress was measured with questionnaires on general and pregnancy-specific stress and anxiety completed by the mothers in gestational week 37. At child age three, mothers filled in questionnaires on children's executive functioning, and externalizing and internalizing behavior. Analyses were performed in an intention-to-treat (ITT), per-protocol, and dose-response approach. Netherlands Trial Register: NL5591. RESULTS: In the ITT approach, fewer internalizing (95% CI = 0.11-1.00, U = 2148.50, r = .24, p = .001) and externalizing (95% CI = 0.04-2.62, t = 2.04, d = 0.38, p = .04) problems were reported in the SSC condition compared to the CAU condition. Multivariate analyses of variance did not show group differences on executive functioning. Additional analyses of covariance showed no moderations by maternal prenatal stress. CONCLUSIONS: Current findings indicate that early daily SSC in full-term infants may foster children's behavioral development. Future replications, including behavioral observations of child behavior to complement maternal reports, are warranted.

Human milk: From complex tailored nutrition to bioactive impact on child cognition and behavior.

Human milk is a highly complex liquid food tailor-made to match an infant's needs. Beyond documented positive effects of breastfeeding on infant and maternal health, there is increasing evidence that milk constituents also impact child neurodevelopment. Non-nutrient milk bioactives would contribute to the (long-term) development of child cognition and behavior, a process termed 'Lactocrine Programming'. In this review we discuss the current state of the field on human milk composition and its links with child cognitive and behavioral development. To promote state-of-the-art methodologies and designs that facilitate data pooling and meta-analytic endeavors, we present detailed recommendations and best practices for future studies. Finally, we determine important scientific gaps that need to be filled to advance the field, and discuss innovative directions for future research. Unveiling the mechanisms underlying the links between human milk and child cognition and behavior will deepen our understanding of the broad functions of this complex liquid food, as well as provide necessary information for designing future interventions.

Maternal sensitivity and child internalizing and externalizing behavior: a mediating role for glucocorticoid receptor gene (NR3C1) methylation?

The early caregiving environment can have lasting effects on child mental health. Animal models suggest that glucocorticoid receptor gene (NR3C1) DNA methylation plays a mediating role in linking more responsive caregiving to improved behavioral outcomes by its impact on the stress regulatory system. In this longitudinal study, we examined whether children's NR3C1 methylation levels mediate an effect of maternal sensitivity in infancy on levels of child internalizing and externalizing behavior in a community sample. Maternal sensitivity of 145 mothers was rated at infant age 5 weeks, 12 months, and 30 months by observing mother-infant interactions. Buccal DNA methylation was assessed in the same children at age 6 years and maternal-reported internalizing and externalizing behavior was assessed at age 6 and 10 years. Higher sensitivity at age 5 weeks significantly predicted lower DNA methylation levels at two NR3C1 CpG loci, although methylation levels at these loci did not mediate an effect of maternal sensitivity on levels of child internalizing and externalizing behavior. Overall, the study provides evidence that maternal sensitivity in early infancy is associated with DNA methylation levels at loci involved in stress regulation, but the significance of this finding for child mental health remains unclear.

A longitudinal study of the gut microbiota during the first three years of life: Links with problem behavior and executive functions at preschool age.

Early life is a sensitive period when microbiota-gut-brain interactions may have important impact on development. This study investigated the associations of the gut microbiota in the first three years of life (two, six, and 12 weeks, and one and three years) with problem behavior and executive functions in N = 64 three-year-old children. Higher relative abundance of Streptococcus at the age of two weeks, as well as its trajectory over time (including ages two, six and 12 weeks, and one and three years), was related to worse executive functions. Higher relative abundance of [Ruminococcus] torques group at the age of three years, as well as its trajectory from one to three years, was associated with less internalizing behavior. Besides, several robust age-specific associations were identified: higher Bifidobacterium relative abundance (age three years) was associated with more internalizing and externalizing issues; higher Blautia relative abundance (age three years) was linked to less internalizing behavior; and increased relative abundance of an unidentified Enterobacteriaceae genus (age two weeks) was related to more externalizing behavior. Our findings provide important longitudinal evidence that early-life gut microbiota may be linked to behavioral and cognitive development in low-risk children.

Are adolescent diet quality and emotional eating predicted by history of maternal caregiving quality and concurrent inhibitory control?

The risk for unhealthy eating behaviour, including poor diet quality and emotional eating, is heightened in adolescence and could result in profound and long-lasting psychological and physical implications. Caregiving quality and adolescents' regulatory skills, such as inhibitory control, may play an essential role in the development of adolescent eating behaviour. This preregistered study investigated whether maternal caregiving throughout the first 14 years of life predicts adolescent diet quality and emotional eating and whether potential associations are mediated by adolescents' inhibitory control. In this low-risk community cohort, maternal caregiving quality was observed at child ages five weeks, 12 months, 2.5, 10, and 14 years. At age 14, diet quality and emotional eating were assessed through self-report. Adolescent inhibitory control was assessed with three behavioural tasks and a maternal report. Mediation analyses were performed with structural equation modelling in R. No evidence was found for links between maternal caregiving quality and adolescent diet quality and emotional eating. Higher levels of adolescent inhibitory control predicted better adolescent diet quality. Longitudinal and experimental studies are needed to investigate directionality, and replication studies are needed in more representative samples (e.g. including high-risk families). Such studies will shed further light on potential links between the history of caregiving behaviour and adolescent regulatory and eating behaviour.

The PedBE clock accurately estimates DNA methylation age in pediatric buccal cells.

The development of biological markers of aging has primarily focused on adult samples. Epigenetic clocks are a promising tool for measuring biological age that show impressive accuracy across most tissues and age ranges. In adults, deviations from the DNA methylation (DNAm) age prediction are correlated with several age-related phenotypes, such as mortality and frailty. In children, however, fewer such associations have been made, possibly because DNAm changes are more dynamic in pediatric populations as compared to adults. To address this gap, we aimed to develop a highly accurate, noninvasive, biological measure of age specific to pediatric samples using buccal epithelial cell DNAm. We gathered 1,721 genome-wide DNAm profiles from 11 different cohorts of typically developing individuals aged 0 to 20 y old. Elastic net penalized regression was used to select 94 CpG sites from a training dataset (n = 1,032), with performance assessed in a separate test dataset (n = 689). DNAm at these 94 CpG sites was highly predictive of age in the test cohort (median absolute error = 0.35 y). The Pediatric-Buccal-Epigenetic (PedBE) clock was characterized in additional cohorts, showcasing the accuracy in longitudinal data, the performance in nonbuccal tissues and adult age ranges, and the association with obstetric outcomes. The PedBE tool for measuring biological age in children might help in understanding the environmental and contextual factors that shape the DNA methylome during child development, and how it, in turn, might relate to child health and disease.

Maternal anxiety forecasts shorter prolongation of pregnancies complicated by early-onset preeclampsia.

PURPOSE: In early-onset preeclampsia, each additional day of pregnancy prolongation reduces offspring infant mortality about 9%. We evaluated if maternal stress at admission to hospital for early-onset preeclampsia predicted admission-to-delivery intervals in days. METHODS: This prospective, longitudinal cohort-study involved 15 singleton pregnancies with a diagnosis of preeclampsia before 34 weeks gestation with intended expectant management. Upon hospital admission, maternal psychological stress was assessed with questionnaires and physiological stress with hair cortisol. Hair samples were analyzed in three hair segments representing the preconception period, and the first and second trimester of pregnancy. RESULTS: Mean pregnancy prolongation was 16.2 days. Higher maternal anxiety at hospital admission significantly correlated with shorter admission-to-delivery intervals (r = - 0.54, p = 0.04). Chronically increased hair cortisol concentrations (i.e. from preconception through the second trimester) of pregnancy tended to be related to shorter admission-to-delivery intervals (p <. 10). CONCLUSION: Higher reported anxiety is, and chronically high hair cortisol tended to be, related with fewer days of prolongation from admission to delivery in women with early-onset preeclampsia. These findings suggest that maternal stress might be a potential determinant of disease progression. Future research into early innovative stress-reducing interventions for early-onset preeclampsia may shed more light on the etiology and treatment of this disease.

Cortisol and testosterone concentrations during the prenatal and postpartum period forecast later caregiving quality in mothers and fathers.

Given that parental caregiving quality affects child development from birth onwards, it is important to detect parents who are at risk for low-quality caregiving as early as possible, preferably before or soon after birth. This study investigated whether cortisol (CORT) and testosterone (T) measured during the last trimester of pregnancy and six weeks postpartum were associated with observed caregiving quality at child age 3 in mothers (N = 63) and fathers (N = 45). CORT and T were measured during an interaction with a simulator infant (pregnancy) and their own infant (postpartum). In mothers, no associations were found with CORT and T during pregnancy, but higher postpartum CORT during a mother-infant interaction was related to higher caregiving quality during toddlerhood. In fathers, the association between T during pregnancy and caregiving quality in toddlerhood was more negative for fathers with low CORT. In contrast to mothers, higher postpartum CORT in fathers was associated with lower caregiving quality in toddlerhood. These findings proved robust after applying the Benjamini-Hochberg procedure to control for false discovery rate. Our findings indicate that CORT and T during the perinatal period can forecast caregiving quality in both mothers and fathers. Moreover, our results provided evidence for the dual-hormone hypothesis, but only in fathers. These findings contribute to our growing understanding on how endocrine measures explain individual differences in caregiving quality in mothers and fathers.

Parents of young infants report poor mental health and more insensitive parenting during the first Covid-19 lockdown.

BACKGROUND: The Covid-19 pandemic has put an unprecedented pressure on families with children. How parents were affected by the first Covid-19 lockdown during the early postpartum period, an already challenging period for many, is unknown. AIM: To investigate the associations between Covid-19 related stress, mental health, and insensitive parenting practices in mothers and fathers with young infants during the first Dutch Covid-19 lockdown. METHODS: The Dutch Covid-19 and Perinatal Experiences (COPE-NL) study included 681 parents of infants between 0 and 6 months (572 mothers and 109 fathers). Parents filled out online questionnaires about Covid-19 related stress, mental health (i.e. anxiety and depressive symptoms), and insensitive parenting. Hierarchical regression models were used to analyze the data. RESULTS: Parents of a young infant reported high rates of Covid-19 related stress, with higher reported stress in mothers compared to fathers. Additionally, the percentages of mothers and fathers experiencing clinically meaningful mental health symptoms during the pandemic were relatively high (mothers: 39.7% anxiety, 14.5% depression; fathers: 37.6% anxiety, 6.4% depression). More Covid-19 related stress was associated with more mental health symptoms in parents and increased insensitive parenting practices in mothers. CONCLUSIONS: The results emphasize the strain of the pandemic on young fathers' and mothers' mental health and its potential negative consequences for parenting. As poor parental mental health and insensitive parenting practices carry risk for worse child outcomes across the lifespan, the mental health burden of the Covid-19 pandemic might not only have affected the parents, but also the next generation.

Effects of skin-to-skin contact on full-term infants' stress reactivity and quality of mother-infant interactions.

Skin-to-skin contact (SSC) between mothers and their infants has beneficial effects in both preterm and full-term infants. Underlying mechanisms are largely unknown. This randomized controlled trial assessed whether daily SSC in full-term mother-infant dyads: (1) decreases infants' cortisol and behavioral reactivity to a mild naturalistic stressor, and (2) facilitates interaction quality between infants and mothers (i.e., improved maternal caregiving behavior and mother-infant adrenocortical synchrony). Pregnant Dutch women (N = 116) were recruited and randomly allocated to an SSC or care-as-usual condition. The SSC condition performed 1 h of SSC daily, from birth until postnatal week 5. In week 5, mothers bathed the infant (known mild stressor). Infant and maternal cortisol was sampled at baseline, 25 and 40 min after bathing, and infant and maternal behavior was rated. Results did not indicate effects of SSC on infant behavioral and cortisol reactivity to the bathing session. Similarly, no effect of SSC was found on maternal caregiving behavior and mother-infant adrenocortical synchrony. In conclusion, the findings provide no evidence that daily mother-infant SSC is associated with full-term infants' behavioral and adrenocortical stress reactivity or mother-infant interaction quality. Future studies should replicate these findings and unveil other potential mechanisms underlying beneficial effects of SSC.

Can Maternal Prenatal Self-Reported and Physiological Distress Predict Postnatal Caregiving Practices?

Maternal prenatal distress is associated with child outcomes, including health, neurocognitive, and socio-emotional development. Knowledge on underlying mechanisms is limited, yet relevant for prevention and intervention. This study investigated whether maternal prenatal distress predicts specific caregiving practices that are known for their effects on child outcomes. Caregiving practices studied were maternal caregiving quality and the initiation and course of breastfeeding and room-sharing. We hypothesized that more maternal prenatal distress would be associated with altered caregiving practices. Participants were 174 healthy mother-child dyads. During the 37th week of pregnancy maternal self-reported distress was assessed using questionnaires, and physiological stress by collecting saliva cortisol. Maternal caregiving quality was observed in postnatal week 5 during infant bathing. Weekly diaries on breastfeeding and daily diaries on room-sharing were completed during the first 6 postnatal months. In a regression analysis, no associations between maternal prenatal distress and caregiving quality were found. Multilevel analyses indicated that maternal prenatal evening cortisol was positively related to the initiation of breastfeeding and room-sharing. Replications are warranted, but these results suggest that breastfeeding and room-sharing initiation may be part of a mechanism underlying links between maternal prenatal physiological stress and child outcomes. As other prenatal cortisol markers and self-reported distress were not found to be related to the caregiving practices, it is likely that alternative mechanisms (co-)exist in explaining links between maternal prenatal distress and child outcomes. Future replication research including child outcomes and (other) potential mechanisms will inform prevention and intervention programs fostering healthy pregnancies and child development.

Daily skin-to-skin contact in full-term infants and breastfeeding: Secondary outcomes from a randomized controlled trial.

This randomized controlled trial evaluated the effect of a 5-week daily skin-to-skin contact (SSC) intervention between mothers and their full-term infants, compared with care-as-usual, on exclusive and continued breastfeeding duration during the first post-natal year. Healthy pregnant women (n = 116) from a community sample were enrolled and randomly allocated to the SSC or care-as-usual condition. SSC mothers were requested to provide one daily hour of SSC for the first five post-natal weeks. Twelve months post-partum, mothers indicated the number of exclusive and continued breastfeeding months. Multiple regression analyses were conducted using intention-to-treat, per-protocol and exploratory dose-response frameworks. In intention-to-treat analyses, exclusive and continued breastfeeding duration was not different between groups (exclusive: 3.61 ± 1.99 vs. 3.16 ± 1.77 months; adjusted mean difference 0.28, 95% confidence interval [CI] -0.33 to 0.89; p = 0.36; continued: 7.98 ± 4.20 vs. 6.75 ± 4.06 months; adjusted mean difference 0.81, 95% CI -0.46 to 2.08; p = 0.21). In per-protocol analyses, exclusive and continued breastfeeding duration was longer for SSC than care-as-usual dyads (exclusive: 4.89 ± 1.26 vs. 3.25 ± 1.80 months; adjusted mean difference 1.28, 95% CI 0.31-2.24; p = 0.01; continued: 10.81 ± 1.97 vs. 6.98 ± 4.08 months; adjusted mean difference 2.33, 95% CI 0.13-4.54; p = 0.04). Exploratory dose-response effects indicated that more SSC hours predicted longer exclusive and continued breastfeeding duration. This study demonstrates that for the total group, the 5-week daily SSC intervention did not extend exclusive and continued breastfeeding duration. However, for mothers performing a regular daily hour of SSC, this simple and accessible intervention may extend exclusive and continued breastfeeding duration by months. Future studies are required to confirm these promising findings. Trial registration: Netherlands Trial Register (NTR5697).

Universal prevention of distress aimed at pregnant women: a systematic review and meta-analysis of psychological interventions.

BACKGROUND: There is sufficient meta-analytic evidence that antenatal interventions for women at risk (selective prevention) or for women with severe psychological symptoms (indicated prevention) are effective in reducing postpartum distress. However, women without risk or severe psychological symptoms might also experience distress. This meta-analysis focused on the effectiveness of preventive psychological interventions offered to universal populations of pregnant women on symptoms of depression, anxiety, and general stress. Paternal and infant outcomes were also included. METHOD: We included 12 universal prevention studies in the meta-analysis, incorporating a total of 2559 pregnant women. RESULTS: Overall, ten studies included depression as an outcome measure, five studies included stress, and four studies anxiety. There was a moderate effect of preventive interventions implemented during pregnancy on the combined measure of maternal distress (d = .52), on depressive symptoms (d = .50), and on stress (d = .52). The effect on anxiety (d = .30) was smaller. The effects were not associated with intervention timing, intervention type, intervention delivery mode, timing of post-test, and methodological quality. The number of studies including partner and/or infant outcomes was too low to assess their effectiveness. CONCLUSIONS: This meta-analysis suggests that universal prevention during pregnancy is effective on decreasing symptoms of maternal distress compared to routine care, at least with regard to depression. While promising, the results with regard to anxiety and stress are based on a considerably lower number of studies, and should thus be interpreted with caution. More research is needed on preventing other types of maternal distress beyond depression. Furthermore, there is a lack of research with regard to paternal distress. Also, given the large variety in interventions, more research is needed on which elements of universal prevention work. Finally, as maternal distress symptoms can affect infant development, it is important to investigate whether the positive effects of the preventive interventions extend from mother to infant. SYSTEMATIC REVIEW REGISTRATION NUMBER: International prospective register of systematic reviews (PROSPERO) registration number: CRD42018098861.

Mothers' Attachment Style as a Predictor of Breastfeeding and Room-Sharing Practices.

OBJECTIVE: To prospectively assess breastfeeding and room-sharing practices during the infant's first 6 months and investigate whether mothers' own adult attachment style predicts the initiation and course of these recommended parenting behaviors. METHOD: This study included 193 mother-infant dyads living in the Netherlands. Diary methodology was used to generate 27 weekly measures of breastfeeding and room-sharing during the infant's first 6 months. Multilevel mixed effects models were used to examine trajectories of breastfeeding and room-sharing and to test whether mothers' own adult attachment style predicted the initiation and course of these behaviors, adjusting for covariates. RESULTS: Most (86%) mothers initiated breastfeeding immediately after birth and the rates of breastfeeding declined steadily over the 6 months (b = -2.47, SE = 0.19, p < .001). Mothers with higher attachment avoidance showed faster decreases in breastfeeding than less avoidant mothers (b = -1.07, SE = 0.21, p < .001). Sixty-four percent of mothers engaged in room-sharing after birth which also decreased steadily over the 6 months (b = -3.51, SE = 0.21, p < .001). Mothers' attachment style did not predict the initiation or course of room-sharing. CONCLUSIONS: Given the major implications of breastfeeding and room-sharing for infants' health, safety, and development, the pediatrics community has issued clear guidelines encouraging these behaviors. Yet many new parents do not adhere to the recommended practices. This study identifies mothers' adult attachment style as a predictor of breastfeeding over time that could be incorporated into interventions for parents.

Effectiveness of a psycho-educational intervention for expecting parents to prevent postpartum parenting stress, depression and anxiety: a randomized controlled trial.

BACKGROUND: The first months postpartum can be challenging for parents, leading to elevated symptoms of parenting stress, depression and anxiety. In turn, distressed parents are at higher risk for providing suboptimal quality of caregiving. As psychoeducational interventions can be effective in reducing psychological distress, the goal of this randomized controlled trial was to examine the effectiveness of low-intensity universal psychoeducational program to prevent postpartum parenting stress, and to enhance parental well-being and caregiving quality. METHOD: Between 26 and 34 weeks of pregnancy, 138 pregnant women and 96 partners were randomized to the intervention or a waitlist control group. The intervention consisted of a booklet, a video, a home visit, and a telephone call. Information was provided on (1) sensitive responsiveness, adapting to the parental role, and attending to own needs; (2) crying patterns; (3) feeding (arrangements); and (4) sleeping (arrangements). The primary outcome was parenting stress postpartum. Secondary outcomes were additional measures of distress (depression and anxiety), parental well-being, and caregiving quality. RESULTS: Both groups showed a rise in distress after birth. No between-group differences were observed on parenting stress, nor on the secondary outcomes. The intervention was rated as useful and of added value by the parents. CONCLUSION: This study offered no evidence that our universal prevention program was effective in decreasing parental distress or in increasing caregiving quality. However, parents found aspects of the intervention useful. More research is needed, including a longer period of follow-up as well as observational measures of parents' responsiveness. TRIAL REGISTRATION: This trial has been registered on 15 September 2016 in the Netherlands National Trial Register, ID: NTR6065, https://www.trialregister.nl/trial/5782 .

Maternal antenatal depression and child mental health: Moderation by genomic risk for attention-deficit/hyperactivity disorder.

Maternal antenatal depression strongly influences child mental health but with considerable inter-individual variation that is, in part, linked to genotype. The challenge is to effectively capture the genotypic influence. We outline a novel approach to describe genomic susceptibility to maternal antenatal depression focusing on child emotional/behavioral difficulties. Two cohorts provided measures of maternal depression, child genetic variation, and child mental health symptoms. We constructed a conventional polygenic risk score (PRS) for attention-deficit/hyperactivity disorder (ADHD) (PRSADHD) that significantly moderated the association between maternal antenatal depression and internalizing problems at 60 months (p = 2.94 × 10-4, R2 = .18). We then constructed an interaction PRS (xPRS) based on a subset of those single nucleotide polymorphisms from the PRSADHD that most accounted for the moderation of the association between maternal antenatal depression and child outcome. The interaction between maternal antenatal depression and this xPRS accounted for a larger proportion of the variance in child emotional/behavioral problems than models based on any PRSADHD (p = 5.50 × 10-9, R2 = .27), with similar findings in the replication cohort. The xPRS was significantly enriched for genes involved in neuronal development and synaptic function. Our study illustrates a novel approach to the study of genotypic moderation on the impact of maternal antenatal depression on child mental health and highlights the utility of the xPRS approach. These findings advance our understanding of individual differences in the developmental origins of mental health.

Parent-Infant Room Sharing During the First Months of Life: Longitudinal Links With Behavior During Middle Childhood.

Current recommendations encourage parent-infant room sharing for the first 6 months of life. This longitudinal study (N = 193) is the first to examine long-term relations of early room sharing with three domains of child behavior: sleep, behavior problems, and prosocial behavior. Information on room sharing was collected daily for infants' first 6 months. At ages 6, 7, and 8 years, outcomes were assessed with maternal and teacher questionnaires and behavioral observations. Early room sharing was not related to sleep problems or behavior problems. Additionally, more weeks of room sharing were positively related to higher maternal ratings of child sleep quality and more prosocial behavior. In conclusion, early room sharing appears to be related to positive, but not negative, behavior outcomes in middle childhood.