High body mass index and sleep problems during pregnancy: A meta‐analysis and meta‐regression of observational studies

Abstract

Summary Despite the well‐established correlation of weight and sleeping problems, little is known about the nature of the association. The present study examined whether pregnant women with high body mass index have a risk of developing sleep problems, and identified any covariates that affect this relationship. We systematically searched electronic databases, specialized journals, various clinical trial registries, grey literature databases and the reference list of the identified studies. All observational studies were obtained from inception until 9 August 2020. The Newcastle–Ottawa Scale was adopted to assess the quality of studies. Stata software was used to conduct meta‐analysis and meta‐regression. Forty‐six observational studies involving 2,240,804 participants across 16 countries were included. Quality assessment scores ranged from 4 to 10 (median = 6). Meta‐analyses revealed that the risk of sleep apnea, habitual snoring, short sleep duration and poor sleep quality is increased in pregnant women with high body mass index, but not for daytime sleepiness, insomnia or restless legs syndrome. Subgroup differences were detected on body mass index between different regions, nature of population, year of publication, age group and study quality. Random‐effects meta‐regression analyses showed that year and quality of publication were covariates on the relationships between pre‐pregnant body mass index and sleep apnea risk. Our review shows that sleep apnea, habitual snoring, short sleep duration and poor sleep quality are important concerns for pregnant women with high body mass index. Developing screening and targeted interventions is recommended to promote efficacious perinatal care.

The relationship between body mass index and sleep in women with risk factors for gestational diabetes mellitus

“…36 To address these variations in findings, a meta-analysis of 46 observational studies has been published, which included articles from 16 different countries, assessing different sleep parameters objectively and subjectively. 27 Findings were in line with this study, but this is a large multicentre study with participants from different nationalities with risk factors for GDM. Additionally, a recent systematic review showed that women with overweight and obesity before pregnancy experienced poor sleep and had a higher risk of obstetric complications and cardiometabolic diseases after pregnancy.…”

“…To address these variations in findings, a meta‐analysis of 46 observational studies has been published, which included articles from 16 different countries, assessing different sleep parameters objectively and subjectively 27 . Findings were in line with this study, but this is a large multicentre study with participants from different nationalities with risk factors for GDM.…”

“… 23 The occurrence of sleep‐disordered breathing is higher during pregnancy compared with non‐pregnant individuals, 24 yet few intervention studies have been reported. 25 , 26 A recent meta‐analysis 27 showed an increased risk of snoring, short sleep duration and poor sleep quality among pregnant women with high BMI; however, most of the studies included were conducted late in gestation.…”

Association Between Objectively Assessed Sleep and Depressive Symptoms During Pregnancy and Post-partum

“…Pregnancy is commonly experienced to go along with increased sleep problems due to the tremendous anatomical, physiological and hormonal changes a pregnant woman's body undergoes (17)(18)(19). Typical self-reported pregnancy-related sleep problems include short sleep duration, poor sleep quality, sleep apnea, habitual snoring, and restless legs syndrome (20,21). While many of these mostly subjective sleep problems are most prominent in the later stages of pregnancy-and may not necessarily be reflected by objective sleep measures relying on rigorous methodology [e.g., (22)]-many women complain of short sleep duration and poor sleep quality already in the first trimester (23)(24)(25).…”