Relationship Between Infant Colic, Maternal Sleep Disruption, and Postpartum Depression Symptoms in First-Time Mothers of Rawalpindi
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Abstract
Background: Infant colic and sleep disruption are common early infancy concerns that may place substantial psychological strain on first-time mothers during the postpartum period. Persistent infant crying can fragment maternal sleep, increase caregiving burden, and contribute to emotional distress, yet local evidence from urban Pakistani settings remains limited. Objective: To assess the association between infant colic, maternal sleep quality, and postpartum depressive symptoms among first-time mothers in the Islamabad-Rawalpindi region. Methods: This cross-sectional observational study included 72 first-time mothers with infants aged 2 weeks to 6 months attending postnatal and pediatric follow-up clinics. Participants were recruited through consecutive sampling. Infant colic symptoms were assessed using a Wessel criteria-based crying assessment, while infant sleep behavior was evaluated using the Brief Infant Sleep Questionnaire. Maternal sleep quality was measured using the Pittsburgh Sleep Quality Index, and postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Data were analyzed using SPSS version 26, with independent-samples t-tests and Pearson correlation applied at p<0.05. Results: Infant colic symptoms were present in 31 infants (43.1%). Mean PSQI and EPDS scores were 8.1 ± 3.2 and 11.6 ± 4.7, respectively, while elevated depressive symptoms were observed in 20 mothers (27.8%). Mothers of infants with colic had significantly higher PSQI scores (10.2 ± 2.9 vs. 6.5 ± 2.4, p<0.001) and EPDS scores (14.1 ± 4.3 vs. 9.7 ± 3.8, p<0.001) than mothers of infants without colic. Infant crying duration correlated positively with PSQI (r=0.58, p<0.001) and EPDS scores (r=0.49, p<0.001), while PSQI and EPDS scores were strongly correlated (r=0.64, p<0.001). Conclusion: Infant colic was significantly associated with poorer maternal sleep quality and higher postpartum depressive symptom burden among first-time mothers. Routine assessment of maternal sleep and emotional well-being during postnatal and pediatric visits may support early identification of mothers requiring additional counseling, sleep support, and mental health referral.
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