Pamela A Geller

Abstract Objectives Women with perinatal depression (WWPD) are at high risk for unhealthy dietary behaviors and suboptimal child feeding practices. Despite mounting evidence supporting the importance of healthful nutrition-related behaviors during and after pregnancy, few behavioral nutrition interventions for WWPDs have been developed. The objectives of this study were to identify nutrition-related challenges and needs among WWPD, and to elucidate the role that feeding plays in mother-infant interaction. Methods Using a qualitative research design, in-depth interviews were conducted with 18 WWPDs and 10 healthcare professionals (HCPs) who work with WWPD. Interviews were audio recorded and transcribed verbatim. Data was thematically analyzed. Transcripts were coded by two research team members and a third member ensured accuracy and resolved discrepancies. Deductive and inductive coding was performed, and codes were refined and subsequently organized into themes. Results WWPD had a mean age of 31 ± 6 years and between 2–4 children. 89% reported college-level education, 56% were non-Hispanic white, and 33% were Black/African American. HCPs were in various specialties related to maternal mental health; 80% had practiced for > 5years. Seven themes with up to three subthemes were identified from interviews with HCPs and WWPDs: 1) Prioritizing mom - institutional and personal; 2) Scarce resources; 3) Body changes - body image and appetite; 4) Importance of support - source of affirmation and greater reliance; 5) Sense of fulfilment associated with infant and young child feeding - bonding and pride; 6) Challenges with breastfeeding - difficult experiences and need for liberalizing recommendations; and 7) Great expectations of motherhood - guilt and shame, overwhelm, and high anxiety. Conclusions WWPD face several barriers to their own healthful nutrition and that of their children, and findings from this study illustrate key considerations for tailoring dietary guidance to meet the unique needs of WWPD. Further, a person-centered approach for breastfeeding guidance is recommended. Funding Sources Drexel University College of Nursing and Health Professions, Dean's Rapid Response Relevant (R3) Grant.

Introduction
Maternal sleep disturbance is common during pregnancy and is associated with adverse maternal and child outcomes, such as postpartum depression and preterm birth. The extent to which sleep disorder symptoms are normative among women of reproductive age, however, is largely unknown. The present study’s primary aim was to explore cumulative sleep morbidity and the incidence of disorder-specific symptoms among reproductive-aged women of different childbearing statuses.
Methods
Sleep morbidity variables were examined cross-sectionally among three groups of reproductive-aged nulliparous women: those 1) currently pregnant (n=148), 2) currently intending to conceive (n=233), and 3) not currently intending to conceive (n=379). All subjects self-reported sleep disorder symptoms at baseline using the Sleep Disorders Symptom Checklist-25 (SDS-CL-25). This instrument measures symptoms related to 13 sleep disorders scaled 0 (never) to 4 (> 5 days per week). Average scores were calculated for each item, each of 13 sleep disorders, and for the whole instrument (0-100).
Results
Initial results indicated that pregnant women (M=22.80, SD=11.49) had a higher rate of cumulative sleep morbidity than women who were intending to conceive (M=20.33, SD=11.14) and women who were not intending to conceive (M=20.15, SD=12.03) (p=.05). Pregnant women also had increased rates of insomnia (M pregnant=8.38, SD=3.77; M intending=6.86, SD=3.60; M not intending=6.53, SD=3.47; p<.001) and restless legs syndrome/periodic limb movement disorder (M pregnant=2.77, SD=3.05; M intending=2.02, SD=2.28; M not intending=1.99, SD=2.43; p= .004) as compared to non-pregnant women.
Conclusion
These data suggest, as is widely held, that pregnant women have greater levels of sleep disturbance than women of a common reproductive age who are currently intending to conceive or who are not currently intending to conceive. The observed sleep disturbance appears to be limited to sleep initiation and maintenance and RLS/PLMs symptomatology. Additional analyses are ongoing.