Association between maternal sleep practices and risk of late stillbirth: a case-control study

Stacey, Tomasina; Thompson, John M. D.; Mitchell, Ed; Ekeroma, Alec; Zuccollo, Jane; McCowan, Lesley

doi:10.1136/bmj.d3403

Cited by 117 publications

(161 citation statements)

References 32 publications

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“…In our study, a PT intervention was implemented in a population of healthy, third-trimester, pregnant women during sleep in a clinical sleep laboratory environment over two nights. This study extends the work of Stacey et al ,2 Gordon et al ,3 McCowan et al ,4 and Warland and Mitchell52 by finding that supine sleep position in late pregnancy can be reduced with PT.…”

Section: Discussionsupporting

confidence: 86%

Modifying maternal sleep position in the third trimester of pregnancy with positional therapy: a randomised pilot trial

et al. 2018

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ObjectiveTo evaluate whether the percentage of time spent supine during sleep in the third trimester of pregnancy could be reduced using a positional therapy device (PrenaBelt) compared with a sham device.DesignA double-blind, randomised, sham-controlled, cross-over pilot trial.SettingConducted between March 2016 and January 2017, at a single, tertiary-level centre in Canada.Participants23 participants entered the study. 20 participants completed the study. Participants were low-risk, singleton, third-trimester pregnant women aged 18 years and older with body mass index <35 kg/m2 at the first antenatal appointment for the index pregnancy and without known fetal abnormalities, pregnancy complications or medical conditions complicating sleep.InterventionsA two-night, polysomnography study in a sleep laboratory. Participants were randomised by computer-generated, one-to-one, simple randomisation to receive either a PrenaBelt or a sham-PrenaBelt on the first night and were crossed over to the alternate device on the second night. Allocation concealment was by unmarked, security-tinted, sealed envelopes. Participants, the recruiter and personnel involved in setting up, conducting, scoring and interpreting the polysomnogram were blinded to allocation.Primary and secondary outcome measuresThe primary outcome was the percentage of time spent supine during sleep. Secondary outcomes included maternal sleep architecture, respiration, self-reported sleep position and feedback.ResultsThe median percentage of sleep time supine was reduced from 16.4% on the sham night to 3.5% on the PrenaBelt night (pseudomedian=5.8, p=0.03). We were unable to demonstrate differences in sleep architecture or respiration. Participants underestimated the time they spent sleeping supine by 7.0%, and six (30%) participants indicated they would make changes to the PrenaBelt. There were no harms in this study.ConclusionsThis study demonstrates that the percentage of sleep time supine during late pregnancy can be significantly reduced via positional therapy.Trial registration numberNCT02377817; Results.

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Section: Discussionsupporting

confidence: 86%

Modifying maternal sleep position in the third trimester of pregnancy with positional therapy: a randomised pilot trial

et al. 2018

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“…A recent study of questionnaires on maternal sleep practices reported that the risk of stillbirth among pregnant women sleeping on the left side was lower than the risk among women sleeping supine or on the right side [21]. The reason was thought to be related to the anatomical position of the inferior vena cava and the aorta.…”

Section: Discussionmentioning

confidence: 99%

Automated Software Analysis of Fetal Movement Recorded during a Pregnant Woman’s Sleep at Home

Nishihara

Ohki²,

Kamata

et al. 2015

PLoS ONE

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Fetal movement is an important biological index of fetal well-being. Since 2008, we have been developing an original capacitive acceleration sensor and device that a pregnant woman can easily use to record fetal movement by herself at home during sleep. In this study, we report a newly developed automated software system for analyzing recorded fetal movement. This study will introduce the system and compare its results to those of a manual analysis of the same fetal movement signals (Experiment I). We will also demonstrate an appropriate way to use the system (Experiment II). In Experiment I, fetal movement data reported previously for six pregnant women at 28-38 gestational weeks were used. We evaluated the agreement of the manual and automated analyses for the same 10-sec epochs using prevalence-adjusted bias-adjusted kappa (PABAK) including quantitative indicators for prevalence and bias. The mean PABAK value was 0.83, which can be considered almost perfect. In Experiment II, twelve pregnant women at 24-36 gestational weeks recorded fetal movement at night once every four weeks. Overall, mean fetal movement counts per hour during maternal sleep significantly decreased along with gestational weeks, though individual differences in fetal development were noted. This newly developed automated analysis system can provide important data throughout late pregnancy.

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“…A controversial observation has been reported recently in a case-control study in which women who slept on their back or on their right side the previous night (before fetal death) had a higher rate of late stillbirth than women who slept on their left side (aOR for back sleeping, 2.54; 95% CI, 1.04-6.18). 124 An editorial commenting on this article concluded that the study should be considered hypothesis-generating rather than hypothesis-testing. 125 The puzzling observation was that women who got up to go to the toilet once or less on the last night before the diagnosis of stillbirth were more likely to have a late fetal death than those who got up more frequently.…”

Section: Maternal Sleep Position and Late Stillbirthmentioning

confidence: 99%

A role for sleep disorders in pregnancy complications: challenges and opportunities

Romero

Badr

2014

American Journal of Obstetrics and Gynecology

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Association between maternal sleep practices and risk of late stillbirth: a case-control study

Abstract: Objectives To determine whether snoring, sleep position, and other sleep practices in pregnant women are associated with risk of late stillbirth.

Cited by 117 publications

References 32 publications

Modifying maternal sleep position in the third trimester of pregnancy with positional therapy: a randomised pilot trial

Modifying maternal sleep position in the third trimester of pregnancy with positional therapy: a randomised pilot trial

Automated Software Analysis of Fetal Movement Recorded during a Pregnant Woman’s Sleep at Home

A role for sleep disorders in pregnancy complications: challenges and opportunities

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