Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

Wang, Ling; Jin, Feng

doi:10.1186/s12884-020-2814-5

Cited by 49 publications

(29 citation statements)

References 54 publications

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“…Researchers have reported that poor sleep quality increases the risk of systemic inflammation, 4 preterm birth, 5,6 longer labour, 7 unplanned caesarean section, 7 gestational diabetes mellitus (GDM), 8,9 depression during both the prenatal and postpartum periods and suicide among pregnant women. [10][11][12] Fortunately, good management of poor sleep during pregnancy can improve maternal and neonatal health.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of and Risk Factors for Poor Sleep During Different Trimesters of Pregnancy Among Women in China: A Cross-Sectional Study

Zhang¹,

Li²,

Fan³

et al. 2021

NSS

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Background The management of poor sleep during pregnancy is important for maternal and foetal health. The aim of the present study was to investigate the prevalence of poor sleep quality and risk factors for poor sleep during different trimesters of pregnancy for better management of sleep during pregnancy. Methods A cross-sectional study was conducted among pregnant women in Foshan Women’s and Children’s Hospital. In total, 2281 pregnant women were analysed, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Cluster logistic regression was used to analyse the risk factors for poor sleep among all participants, and logistic regression models were built to identify potential risk factors for poor sleep quality in different trimesters of pregnancy. Results Over half of the participants reported poor sleep quality (51.8%). The rate of poor sleep was lowest in the second trimester. Women who were unmarried had >12 years of education, exercised <3 days/week, were in the third trimester, had a high level of nausea and vomiting during pregnancy (NVP) and had a history of infertility had a higher risk of poor sleep. Pregnancy-related factors contributed most to poor sleep. In the first trimester, the main risk factors for poor sleep were a history of infertility and a high level of NVP. In the second trimester, only a high level of NVP was a risk factor for poor sleep. In the last trimester, the risk factors for poor sleep were more education years, exercise <3 days/week and high levels of NVP. Conclusion The prevalence and risk factors for poor sleep were different in different trimesters. Clinicians should screen and address poor sleep prior to the first and, especially, the third trimester of pregnancy. Management of poor sleep should be consistent throughout pregnancy and be adjusted in different trimesters.

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Section: Introductionmentioning

confidence: 99%

Prevalence of and Risk Factors for Poor Sleep During Different Trimesters of Pregnancy Among Women in China: A Cross-Sectional Study

Zhang¹,

Li²,

Fan³

et al. 2021

NSS

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“…In addition, given to inconsistency in the definition of long sleep duration in previous studies [ 42 ], we also performed the same analyses using ≥10 h of sleep per day as excessive sleep duration and found that sleep duration ≥10 h/day had similar effects on CD after adjusting for confounding factors (OR:1.18, 95%CI:1.08–1.29). Excessive sleep duration increased risk of a number of pregnancy complications such as GDM [ 34 ], preeclampsia and hypertension [ 17 ], late stillbirth [ 43 ], and preterm birth [ 44 ]. Therefore, avoiding excessive sleep duration might be an important antenatal practice not only to lower the risk of CD but also to reduce other pregnancy complications such as GDM [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Physical activity and sleep duration during pregnancy have interactive effects on caesarean delivery: a population-based cohort study in Tianjin, China

Yang

et al. 2021

BMC Pregnancy Childbirth

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Background There were inconsistent findings in the literature regarding the associations of physical activity and sleep duration during pregnancy with caesarean delivery for different reasons. It was also unknown whether physical activity and sleep duration during pregnancy had interactive effects on the risks of different types of caesarean delivery. The study aimed to investigate the effects of physical activity, sleep duration and their interactions on the risk of caesarean delivery for medical reasons and non-medical reasons. Methods From October 2010 to August 2012, a prospective population-based cohort of 13,015 pregnant women was established in six central urban districts of Tianjin, China. Pregnancy outcomes were retrieved from an electronic database and caesarean delivery was divided into caesarean delivery for medical reasons and caesarean delivery for non-medical reasons. Physical activity and sleep status were collected at 24–28 weeks of gestation using self-reported questionnaires. Logistic regression and additive interaction were used to examine physical activity, sleep duration and their interactive effects on risk of caesarean delivery. Results In the cohort, 5692 (43.7%) and 2641 (20.3%) of women had caesarean delivery for medical reasons and non-medical reasons, respectively. Low physical activity increased the risk of caesarean delivery for medical reasons (adjusted OR: 1.13, 95%CI 1.04–1.23) but not caesarean delivery for non-medical reasons. Sleep duration < 7 h/day and poor sleep quality were not associated with caesarean delivery. Sleep duration ≥9 h/day increased the risk of caesarean delivery for medical reasons (1.12, 1.02–1.22) and caesarean delivery for non-medical reasons (1.16, 1.05–1.29). Co-presence of low physical activity and sleep duration ≥9 h/day increased risk of caesarean delivery (1.25, 1.12–1.41), and their additive interaction was statistically significant for caesarean delivery for medical reasons but not for caesarean delivery for non-medical reasons. Conclusions Low physical activity and excessive sleep duration during pregnancy each increased the risk of caesarean delivery, and they had an interactive effect on the risk of caesarean delivery for medical reasons but not on the risk of caesarean delivery for non-medical reasons. Increasing physical activity and maintaining recommended sleep duration during pregnancy may have benefits for perinatal health.

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“…However, few studies have evaluated the impact of CPAP in pregnancy [ 42 ], particularly as it relates to perinatal mood. In addition, barriers to CPAP treatment in pregnancy include risk for poor adherence, which may be secondary to baseline poor sleep [ 3 ] or demands of childcare and other responsibilities that may take precedence over their health. Future research on the effects of early CPAP usage on prenatal depressive symptoms is warranted given the findings in this study and the challenges associated with treating SDB in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep quality worsens during pregnancy [ 1 , 2 ], and poor sleep in pregnancy is associated with adverse outcomes of pre-term birth [ 3 ], longer labor and delivery time [ 4 , 5 ], and postpartum depressive symptoms [ 1 ]. Sleep disordered breathing (SDB)—a spectrum of disorders characterized by interruptions in airflow due to obstruction of the upper airway that leads to fragmented sleep and diminished sleep quality—can disrupt sleep in expectant mothers.…”

Section: Introductionmentioning

confidence: 99%

Sleep Disordered Breathing Measures in Early Pregnancy Are Associated with Depressive Symptoms in Late Pregnancy

et al. 2021

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Sleep disordered breathing (SDB) and depression are both common complications of pregnancy and increase risk for adverse maternal and neonatal outcomes. SDB precedes onset of depression in non-pregnant adults; however, the longitudinal relationship has not been studied in pregnancy. The present research examined temporal associations between SDB and depressive symptoms in 175 pregnant women at risk for SDB (based on frequent snoring and obesity), but without an apnea hypopnea index of ≥5 events per hour at enrollment. Women completed a self-report assessments of depressive symptoms using PHQ-9 and in-home level III sleep apnea monitoring at approximately 12- and 32-weeks’ gestation. We also assessed the risk for SDB using the Berlin Questionnaire in early pregnancy. Results revealed that measures of SDB in early pregnancy as assessed by in-home sleep study, but not by self-reported SDB, predicted elevated depressive symptoms in late pregnancy. SDB in late pregnancy was not associated with depressive symptoms. To conclude, these findings suggest that SDB may increase the risk for elevated depressive symptoms as pregnancy progresses.

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Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies

Cited by 49 publications

References 54 publications

Prevalence of and Risk Factors for Poor Sleep During Different Trimesters of Pregnancy Among Women in China: A Cross-Sectional Study

Prevalence of and Risk Factors for Poor Sleep During Different Trimesters of Pregnancy Among Women in China: A Cross-Sectional Study

Physical activity and sleep duration during pregnancy have interactive effects on caesarean delivery: a population-based cohort study in Tianjin, China

Sleep Disordered Breathing Measures in Early Pregnancy Are Associated with Depressive Symptoms in Late Pregnancy

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