Racial discrimination and perinatal sleep quality

Francis, Byron F.; Klebanoff, Mark A.; Oza-Frank, Reena

doi:10.1016/j.sleh.2017.05.012

Cited by 26 publications

(17 citation statements)

References 37 publications

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“…Subgroup analyses revealed that the prevalence of poor sleep quality was higher in postnatal (67.2%, 95% CI: 57.6-75.5%) than in perinatal women (44.5%, 95% CI: 37.6-51.6%), which confirmed some (47), but not all studies (87)(88)(89). For instance, one longitudinal study using the PSQI found that 71% of women reported poor sleep in prenatal assessment and the figure increased to 77% during postpartum period (47). However, another longitudinal study found that women's sleep quality decreased progressively from their second to third trimester, but gradually improved during postnatal period (87).…”

Section: Discussionsupporting

confidence: 58%

“…Commonly reported contributing factors of poor sleep quality included level of progesterone (37), physical discomforts (85), the infant's sleep-wake patterns, and the feeding practices (86). Subgroup analyses revealed that the prevalence of poor sleep quality was higher in postnatal (67.2%, 95% CI: 57.6-75.5%) than in perinatal women (44.5%, 95% CI: 37.6-51.6%), which confirmed some (47), but not all studies (87)(88)(89). For instance, one longitudinal study using the PSQI found that 71% of women reported poor sleep in prenatal assessment and the figure increased to 77% during postpartum period (47).…”

Section: Discussionmentioning

confidence: 55%

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Prevalence of Poor Sleep Quality in Perinatal and Postnatal Women: A Comprehensive Meta-Analysis of Observational Studies

Yang

et al. 2020

Front. Psychiatry

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Background: Sleep disturbance is common in perinatal and postnatal women, but the epidemiology of sleep problems is highly variable in these populations. This was a metaanalysis that examined the prevalence of poor sleep quality and its correlates among perinatal and postnatal women.Methods: A systematic search of both international and Chinese databases (PubMed, EMBASE, PsycINFO, Web of Science, CNKI, and Wangfang) was performed. Studies with data on sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) were included.Results: Forty-two studies were included for analyses. The prevalence of poor sleep quality was 54.2% (95% CI: 47.9-60.5%) in perinatal and postnatal women, with 44.5% (95% CI: 37.6-51.6%) in perinatal women and 67.2% (95% CI: 57.6-75.5%) in postnatal women. The pooled total PSQI score was 7.54 ± 0.40 (95% CI: 6.75-8.33), while the average PSQI component scores varied from 0.13 ± 0.04 for use of sleeping medication to 1.51 ± 0.17 for habitual sleep efficiency. Maternal age, study site, survey year, comorbidity, PSQI cut-off value, and quality assessment score had significant moderating effects on the prevalence of poor sleep quality. Conclusion:Given the negative impact of poor sleep quality on health outcomes and well-being, regular screening for poor sleep quality and effective interventions should be conducted for this population.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 55%

Prevalence of Poor Sleep Quality in Perinatal and Postnatal Women: A Comprehensive Meta-Analysis of Observational Studies

Yang

et al. 2020

Front. Psychiatry

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“…Enrollment of a generally healthy sample also reduced the potential for confounding. The EOD has been extensively studied and is a well validated tool for use among African American women, including for the prediction of outcomes of interest during pregnancy (Francis et al, 2017). Also of note, biologic parameters were standardized to gestational age and sampling time of day windows (removed from awakening, exercise, or caffeine intake), with further statistical controls applied as appropriate to account for prenatal and diurnal fluctuations in cortisol output.…”

Section: Discussionmentioning

confidence: 99%

“…The PSQI has a Cronbach’s α of 0.83 at the individual item level and test-retest reliability of 0.85 for global scores (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989). During pregnancy, sleep quality assessed by the PSQI appears to be susceptible to both the physiologic changes associated with the growing fetus (Sedov, Cameron, Madigan, & Tomfohr-Madsen, 2017) and psychological factors (Francis, Klebanoff, & Oza-Frank, 2017). The 14-item Perceived Stress Scale (PSS) was administered to quantify perceptions of stress within the month prior to the study visit (Cohen, Kessler, & Underwood Gordon, 1995).…”

Section: Methodsmentioning

confidence: 99%

Racial discrimination and leukocyte glucocorticoid sensitivity: Implications for birth timing

Gillespie

Anderson

2018

Social Science & Medicine

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Rationale. Psychological stress-induced cortisol elevations appear to contribute to preterm birth. Yet, some studies suggest that the biological ramifications of racial discrimination-associated stress are unique and may involve development of decreased glucocorticoid sensitivity despite normalized cortisol levels. Objective. In this study, we examined the effects of racial discrimination on maternal cortisol output, leukocyte glucocorticoid sensitivity, and the degree of correspondence between cortisol levels and birth timing in an African American cohort. Method. A generally healthy prospective cohort was enrolled at 28 to 32 weeks gestation (n=91). The Experiences of Discrimination scale was administered, whole blood collected, and plasma cortisol levels, cytokine levels, and leukocyte counts quantified for examination of patterns of endogenous feedback. Results. Racial discrimination in the mid-tertile was associated with greater maternal cortisol levels than the bottom tertile among women reporting internalizing responses (b*=0.68, p=0.001). Decreased leukocyte glucocorticoid sensitivity was witnessed at greater frequencies of experiences of racial discrimination, as evidenced by decreased correspondence between maternal cortisol levels and plasma IL-8 levels, monocyte counts, and lymphocyte counts (ps≤0.043). The association between maternal cortisol levels and birth timing differed by discrimination tertile (p values≤0.005), with greater cortisol levels predictive of earlier birth among women without (b*=−0.59, p<0.001) but not with racial discrimination (ps≥0.497). Conclusion. We provide novel evidence of decreased glucocorticoid sensitivity at increasing frequency of exposure to racial discrimination. Our findings suggest that the biology of preterm birth may depend upon racial discriminatory exposures, favoring pathways dependent upon glucocorticoid-induced increases in leukocyte tissue surveillance versus glucocorticoid resistance-associated inflammatory aberrations at increasing levels of exposure. Precision approaches to prenatal care are sorely needed to combat preterm birth, particularly among African American women, with efforts dependent upon further research examining the pathways contributing to the syndrome dependent upon the totality of an individual’s exposures.

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“…This study includes women enrolled during pregnancy in the Ohio Perinatal Research Network Perinatal Research Repository (PRR). 10 The PRR recruited women at several of the antenatal clinics at The Ohio State University Wexner Medical Center (OSUWMC) beginning in 2010. Many of the women were recruited from the prematurity clinic, which mainly received referrals of women who had a preterm infant in the past.…”

Section: Methodsmentioning

confidence: 99%

Marijuana Use during Pregnancy and Preterm Birth: A Prospective Cohort Study

2020

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Objective The aim of this study is to estimate the association between marijuana use during pregnancy and total, spontaneous and indicated preterm birth. Study Design Prospective cohort study of women receiving antenatal care at The Ohio State University from 2010 to 2015. Marijuana use was assessed by questionnaire, record abstraction, and urine toxicology. Women were followed through the end of pregnancy. Relative risks were assessed with Poisson regression and time to delivery with proportional hazard models. Results Of 363 eligible women, 119 (33%) used marijuana in pregnancy by at least one measure. In this high-risk cohort, preterm birth occurred to 36.0% of users and 34.6% of nonusers (p = 0.81). The unadjusted relative risk of all preterm birth was 1.06 (95% confidence interval [CI]: 0.76–1.47); the adjusted relative risk was similar 1.04 (95% CI: 0.72–1.50). Spontaneous preterm birth was nonsignificantly elevated among users before 1.32 (95% CI: 0.89–1.96), and after 1.21 (95% CI: 0.76–1.94) adjustment. Indicated preterm birth was nonsignificantly reduced before 0.52 (95% CI: 0.22–1.23) and after 0.75 (95% CI: 0.29–2.15) adjustment. The unadjusted hazard ratio (HR) for time to preterm birth was 1.26 (95% CI: 0.84–2.00); the adjusted HR was 1.32 (95% CI: 0.80–2.07). Both unadjusted 1.77 (95% CI: 1.06–2.93) and adjusted 2.16 (95% CI: 1.16–4.02) HRs for spontaneous preterm birth were significantly elevated, primarily due to an increased risk of spontaneous birth <28 weeks among users. The unadjusted and adjusted HRs for time to indicated preterm birth were 0.69 (95% CI: 0.33–1.43) and 0.58 (95% CI: 0.23–1.46). Conclusion Marijuana use was not associated with total preterm birth in this cohort, suggesting that among women already at high risk of preterm birth, marijuana does not increase risk further. However, there was a suggestion that pregnant women who use marijuana may deliver earlier, particularly from spontaneous preterm birth, than women who do not use marijuana.

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Racial discrimination and perinatal sleep quality

Cited by 26 publications

References 37 publications

Prevalence of Poor Sleep Quality in Perinatal and Postnatal Women: A Comprehensive Meta-Analysis of Observational Studies

Prevalence of Poor Sleep Quality in Perinatal and Postnatal Women: A Comprehensive Meta-Analysis of Observational Studies

Racial discrimination and leukocyte glucocorticoid sensitivity: Implications for birth timing

Marijuana Use during Pregnancy and Preterm Birth: A Prospective Cohort Study

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