Ultrasound evaluation of fetal adrenal gland volume. The role of fetal adrenal glands in the pathogenesis of preterm labor

Krzyżanowski, Arkadiusz; Karwasik-Kajszczarek, Katarzyna; Dymanowska-Dyjak, Izabela; Kondracka, Adrianna; Kwaśniewska, Anna

doi:10.17772/gp/1690

Cited by 2 publications

(1 citation statement)

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“…Another potential mechanism for the observed associations of sleep deprivation, vital exhaustion and preterm birth involves the hypothalamic-pituitary-adrenal (HPA) axis, the hormonal system that appears to be most strongly associated with preterm labor [ 34 , 35 ]. There is evidence of an association between sleep disturbances and the HPA axis in the general population [ 36 – 38 ].…”

Section: Discussionmentioning

confidence: 99%

Sleep duration, vital exhaustion, and odds of spontaneous preterm birth: a case–control study

Kajeepeta

Sanchez

Gelaye

et al. 2014

BMC Pregnancy Childbirth

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BackgroundPreterm birth is a leading cause of perinatal morbidity and mortality worldwide, resulting in a pressing need to identify risk factors leading to effective interventions. Limited evidence suggests potential relationships between maternal sleep or vital exhaustion and preterm birth, yet the literature is generally inconclusive.MethodsWe examined the relationship between maternal sleep duration and vital exhaustion in the first six months of pregnancy and spontaneous (non-medically indicated) preterm birth among 479 Peruvian women who delivered a preterm singleton infant (<37 weeks gestation) and 480 term controls who delivered a singleton infant at term (≥37 weeks gestation). Maternal nightly sleep and reports of vital exhaustion were ascertained through in-person interviews. Spontaneous preterm birth cases were further categorized as those following either spontaneous preterm labor or preterm premature rupture of membranes. In addition, cases were categorized as very (<32 weeks), moderate (32–33 weeks), and late (34- <37 weeks) preterm birth for additional analyses. Logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).ResultsAfter adjusting for confounders, we found that short sleep duration (≤6 hours) was significantly associated with preterm birth (aOR = 1.56; 95% CI 1.11-2.19) compared to 7–8 hours of sleep. Vital exhaustion was also associated with increased odds of preterm birth (aOR = 2.41; 95% CI 1.79-3.23) compared to no exhaustion (Ptrend <0.001). These associations remained significant for spontaneous preterm labor and preterm premature rupture of membranes. We also found evidence of joint effects of sleep duration and vital exhaustion on the odds of spontaneous preterm birth.ConclusionsThe results of this case–control study suggest maternal sleep duration, particularly short sleep duration, and vital exhaustion may be risk factors for spontaneous preterm birth. These findings call for increased clinical attention to maternal sleep and the study of potential intervention strategies to improve sleep in early pregnancy with the aim of decreasing risk of preterm birth.

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