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Na M, Shetty SS, Niu X, Hinkle SN, Zhang C, Gao X. Sleep duration, napping behaviors and restless legs syndrome during pregnancy and the trajectories of ultrasonographic measures of fetal growth: Findings from the NICHD Fetal Growth Studies-Singletons. Sleep Health 2024:S2352-7218(24)00087-1. [PMID: 38862351 DOI: 10.1016/j.sleh.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVES Given the plausible mechanisms and the lacking of empirical evidence, the study aims to investigate how gestational sleep behaviors and the development of sleep disorders, such as restless legs syndrome, influence ultrasonographic measures of fetal growth. METHODS The study included 2457 pregnant women from the NICHD Fetal Growth Studies - Singletons (2009-2013), who were recruited between 8-13 gestational weeks and followed up to five times during pregnancy. Women were categorized into six groups based on their total sleep hours and napping frequency. The trajectory of estimated fetal weight from 10-40weeks was derived from three ultrasonographic measures. Linear mixed effect models were applied to model the estimated fetal weight in relation to self-reported sleep-napping behaviors and restless legs syndrome status, adjusting for age, race and ethnicity, education, parity, prepregnancy body mass index category, infant sex, and prepregnancy sleep-napping behavior. RESULTS From enrollment to near delivery, pregnant women's total sleep duration and nap frequency declined and restless legs syndrome symptoms frequency increased generally. No significant differences in estimated fetal weight were observed by sleep-napping group or by restless legs syndrome status. Results remained similar in sensitivity analyses and stratified analyses by women's prepregnancy body mass index category (normal vs. overweight/obese) or by infant sex. CONCLUSIONS Our data indicate that there is no association between sleep during pregnancy-assessed as total sleep duration and napping frequency, nor restless legs syndrome symptoms-and fetal growth from weeks 10 to 40 in healthy pregnant women.
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Affiliation(s)
- Muzi Na
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Samidha Sudhakar Shetty
- Department of Mathematical Sciences, College of Letters and Science, Montana State University, Bozeman, Montana, USA
| | - Xiaoyue Niu
- Department of Statistics, Eberly College of Science, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Stefanie N Hinkle
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cuilin Zhang
- Global Center for Asian Women's Health (GloW) and Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE), National University of Singapore, Singapore, Singapore; Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
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Li Z, Cui S, Wang H, Xiong W, Han Y, Dai W, Xi W, Cui T, Zhang X. Associations of maternal sleep trajectories during pregnancy and adverse perinatal outcomes: a prospective cohort study. Sleep Med 2024; 117:71-78. [PMID: 38513533 DOI: 10.1016/j.sleep.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Sleep problems are common in pregnant women and sleep is altered during pregnancy. However, the associations between sleep trajectory patterns and adverse maternal and neonatal outcomes are unclear. The current study aims to identify sleep trajectory patterns and explore their associations with adverse perinatal outcomes in a prospective cohort study. METHODS Pregnant women (N = 232) completed the Pittsburgh Sleep Quality Index each trimester during pregnancy in Tianjin, China. Perinatal outcomes were extracted from the hospital delivery records. Latent class growth analysis (LCGA) described the trajectories of sleep timing, duration, and efficiency. Multivariable linear regression and multivariable logistic regression were employed to evaluate associations between sleep trajectory patterns and perinatal outcomes. RESULTS Trajectories were identified for bedtime (early, 49.1%; delaying, 50.9%), wake-up time (early, 82.8% of the sample; late, 17.2%), duration (short, 5.2%; adequate 78.0%; excessive, 16.8%), and efficiency (high, 88.4%; decreasing, 11.6%). Compared with women in more optimal sleep groups, those in the late wake-up, excessive duration, and decreasing efficiency groups had babies with shorter birth lengths (β range, -0.50 to -0.28, p < 0.05). Moreover, women in the decreasing efficiency group had babies with lower birth weight (β, -0.44; p < 0.05). Women in the delaying bedtime group had greater odds of preterm delivery (OR, 4.57; p < 0.05), while those in the decreasing efficiency group had greater odds of cesarean section (OR, 3.12; p < 0.05). CONCLUSIONS Less optimal sleep trajectory patterns during pregnancy are associated with perinatal outcomes. Therefore, early assessment of maternal sleep during pregnancy is significant for identifying at-risk women and initiating interventions to reduce perinatal outcomes.
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Affiliation(s)
- Zhi Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Shanshan Cui
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Hui Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Wenjuan Xiong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Yu Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Wei Dai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Wei Xi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Tingkai Cui
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China; Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, 300070, China.
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Wang K, Liu J, Xie J, Yong Z, Li H, Wang L, Xia N, Bai T, Wang H, Wang L. Sleep deprivation from mid-gestation leads to impaired of motor coordination in young offspring mice with microglia activation in the cerebellar vermis. Sleep Med 2024; 115:193-201. [PMID: 38367362 DOI: 10.1016/j.sleep.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/04/2024] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE To investigate the effects of mid-pregnancy sleep deprivation (SD) in C57BL/6 J mice on the motor coordination of the offspring and to explore the potential mechanism of microglia activation in the cerebellar vermis of the offspring involved in the induction of impaired motor coordination development. METHODS C57BL/6 J pregnant mice were randomly divided into the SD and control groups. SD was implemented by the multi-platform method from first day of the middle pregnancy (gestation day 8, GD8). At postnatal day 21 (PND21), we measured the development of motor behavior and collected cerebellar vermis tissues to observe the activation of microglia by H&E staining, the expression of microglia-specific markers ionized calcium-binding adaptor molecule-1 (Iba-1) and cluster of differentiation 68 (CD68) by immunohistochemical, and interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor -α (TNF-α) by real-time quantitative PCR (RT-qPCR). RESULTS In the offspring of SD group, comparing to the control group, the total time of passage and the reverse crawl distance in the balance beam test, and the frequency of falls from the suspension cord was increased; with lower max rotational speed and shorter duration in the rotarod experiment. Further, we found that the microglia of cerebellar vermis tissues emerged an amoeba-like activation. The mean gray value of Iba-1 was lower, the density of positive cells of CD68 and the expression levels of IL-6 and TNF-α were increased. CONCLUSIONS The motor coordination of offspring is impaired, accompanying a SD from mid-pregnancy, and the cerebellar vermis showed microglia activation and pro-inflammatory response. It suggested the adverse effects of SD from mid-gestation on the development of motor coordination through the inflammatory response in the cerebellar vermis of the offspring.
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Affiliation(s)
- Kai Wang
- Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China.
| | - Jin Liu
- Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China.
| | - Jialin Xie
- Department of Pathology, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
| | - Zhongtian Yong
- Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China.
| | - Han Li
- Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China.
| | - Liyan Wang
- Department of Basic Medicine, Fenyang College of Shanxi Medical University, Luliang, 032299, China.
| | - Na Xia
- Department of Environmental Health, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China.
| | - Tao Bai
- Department of Pathology, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
| | - Hongxing Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, National Center for Neurological Disorders, National Clinical Research Center for Geriatric Diseases, Capital Medical University, Beijing, 100053 China; Beijing Institute of Brain Disorders, Beijing, 100069, China; Institute of Special Medical Sciences, School of Forensic Medicine, Shanxi Medical University, Taiyuan, 030001, China.
| | - Li Wang
- Department of Child and Adolescent Health, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention, Ministry of Education, Shanxi Medical University, Taiyuan, 030001, China; Center for Early Childhood Development, Shanxi Medical University, Taiyuan, 030001, China.
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Liu Q, Song L, Fan G, Wu M, Bi J, Xu L, Xiong C, Xia W, Cao Z, Xu S, Wang Y. Associations of self-reported sleep duration and sleep quality during pregnancy with newborn telomere length. Sleep Health 2023; 9:475-481. [PMID: 37230863 DOI: 10.1016/j.sleh.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/01/2023] [Accepted: 03/05/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Telomere length (TL) at birth is considered a potential biomarker for lifelong health. Although maternal sleep disturbance has been linked to a series of adverse pregnancy outcomes, evidence on the effect of maternal sleep on newborn TL remains scarce. Therefore, we aim to investigate the association of maternal sleep duration and sleep quality with newborn TL. METHODS A total of 742 mother-newborn pairs were recruited from Wuhan Children's Hospital between November 2013 and March 2015. Cord blood TL was measured using real-time quantitative polymerase chain reaction. Maternal sleep duration and quality during late pregnancy were obtained via questionnaires. Multivariate linear regression models were used to estimate the effects of maternal sleep duration and sleep quality on newborn TL. RESULTS A total of 742 maternal-newborn pairs were included in the analyses. Mothers sleeping ≥10 hours had a 9.30% (95% CI: 2.09%, 15.99%) shorter newborn TL than those sleeping 7-<9 hours. However, the association in mothers with short sleep duration (<7 hours) did not reach statistical significance. Compared to mothers with good sleep quality, those with poor sleep quality had a 9.91% (95% CI: 4.06%, 15.40%) shorter newborn TL. We observed a joint effect of sleep duration and sleep quality on newborn telomere shortening. Women with sleep duration ≥10 hours and poor sleep quality were most likely to have newborns with short TL (percent change:-19.66%, 95% CI: -28.42, -9.84%). CONCLUSIONS Long sleep duration and poor sleep quality during late pregnancy were associated with shorter newborn TL.
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Affiliation(s)
- Qing Liu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Gaojie Fan
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingyang Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianing Bi
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Luli Xu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chao Xiong
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhongqiang Cao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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5
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Li YS, Lee HC, Huang JP, Lin YZ, Au HK, Lo YC, Chien LC, Chao HJ, Estinfort W, Chen YH. Adverse effects of inadequate sleep duration patterns during pregnancy on toddlers suspected developmental delay: A longitudinal study. Sleep Med 2023; 105:68-77. [PMID: 36966578 DOI: 10.1016/j.sleep.2023.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/30/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Although studies have reported the effects of inadequate sleep on maternal health, few have examined the relationships of maternal sleep patterns with fetal health and early childhood development. This study investigated maternal sleep duration patterns from early pregnancy to 3-years postpartum and their effects on birth outcomes and child development. METHODS This study recruited pregnant women and their partners during prenatal visits at five selected hospitals in the Taipei area; follow-up lasted from July 2011 to April 2021. A total of 1178 parents completed self-reported assessments from early pregnancy until childbirth and 544 completed eight assessments up to 3-years postpartum. Generalized estimated equation models were used for analyses. RESULTS Group-based trajectory modeling was used to identify four trajectories of sleep duration patterns. Although maternal sleep duration was not associated with birth outcomes, maternal "short decreasing" and "stably short" sleep patterns were associated with a higher risk of suspected overall developmental delay and language developmental delay, respectively. Furthermore, an "extremely long decreasing" pattern was associated with a higher risk of suspected overall developmental delay, [adjusted odds ratio (aOR) = 2.97, 95% confidence interval (CI):1.39-6.36)], gross motor delay, (aOR = 3.14, 95% CI: 1.42-6.99) and language developmental delay (aOR = 4.59, 95% CI:1.62-13.00). The results were significant for the children of multiparous women. CONCLUSIONS We identified a U-shaped distribution of risk between offspring developmental delay and maternal prenatal sleep duration, with the highest risk levels on both ends of the maternal prenatal sleep duration pattern. Interventions for maternal sleep are relatively straightforward to implement and should thus be a key part of standard prenatal care.
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Nevarez-Brewster M, Demers CH, Mejia A, Haase MH, Bagonis MM, Kim SH, Gilmore JH, Hoffman MC, Styner MA, Hankin BL, Davis EP. Longitudinal and prospective assessment of prenatal maternal sleep quality and associations with newborn hippocampal and amygdala volume. Dev Cogn Neurosci 2022; 58:101174. [PMID: 36375383 PMCID: PMC9661438 DOI: 10.1016/j.dcn.2022.101174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/12/2022] [Accepted: 11/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rapid maturation of the fetal brain renders the fetus susceptible to prenatal environmental signals. Prenatal maternal sleep quality is known to have important health implications for newborns including risk for preterm birth, however, the effect on the fetal brain is poorly understood. METHOD Participants included 94 pregnant participants and their newborns (53% female). Pregnant participants (Mage = 30; SDage= 5.29) reported on sleep quality three times throughout pregnancy. Newborn hippocampal and amygdala volumes were assessed using structural magnetic resonance imaging. Multilevel modeling was used to test the associations between trajectories of prenatal maternal sleep quality and newborn hippocampal and amygdala volume. RESULTS The overall trajectory of prenatal maternal sleep quality was associated with hippocampal volume (left: b = 0.00003, p = 0.013; right: b = 0.00003, p = .008). Follow up analyses assessing timing of exposure indicate that poor sleep quality early in pregnancy was associated with larger hippocampal volume bilaterally (e.g., late gestation left: b = 0.002, p = 0.24; right: b = 0.004, p = .11). Prenatal sleep quality was not associated with amygdala volume. CONCLUSION These findings highlight the implications of poor prenatal maternal sleep quality and its role in contributing to newborn hippocampal development.
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Affiliation(s)
| | - Catherine H Demers
- University of Denver, Department of Psychology, United States; University of Colorado Anschutz Medical Campus, Department of Psychiatry, United States
| | - Alexandra Mejia
- University of Denver, Department of Psychology, United States
| | | | - Maria M Bagonis
- University of North Carolina - Chapel Hill, Department of Psychiatry, United States
| | - Sun Hyung Kim
- University of North Carolina - Chapel Hill, Department of Psychiatry, United States
| | - John H Gilmore
- University of North Carolina - Chapel Hill, Department of Psychiatry, United States
| | - M Camille Hoffman
- University of Colorado Anschutz Medical Campus, Department of Psychiatry, United States; University of Colorado Denver School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, United States
| | - Martin A Styner
- University of North Carolina - Chapel Hill, Department of Psychiatry, United States; University of North Carolina - Chapel Hill, Department of Computer Science, United States
| | - Benjamin L Hankin
- University of Illinois at Urbana-Champaign, Department of Psychology, United States
| | - Elysia Poggi Davis
- University of Denver, Department of Psychology, United States; University of California, Irvine, Department of Pediatrics, United States
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Zhong C, Chen R, Zhou X, Zhang Y, Liu C, Huang L, Li Q, Xu S, Chen X, Xiong T, Wang W, Gao Q, Zhang H, Wu Y, Hong M, Wu J, Cui W, Li X, Wang W, Lin L, Wang H, Gao D, Li N, Li D, Zhang G, Wang X, Zhang X, Wu M, Yang S, Cao X, Tan T, Tu M, Guo J, Hu W, Zhu W, Xiao D, Gong L, Zhang H, Liu J, Yang S, Wei S, Xiao M, Sun G, Xiong G, Ni Z, Wang J, Jin Z, Yang X, Hao L, Yang H, Yang N. Cohort Profile: The Tongji Maternal and Child Health Cohort (TMCHC). Int J Epidemiol 2022; 52:e152-e161. [PMID: 36343093 DOI: 10.1093/ije/dyac209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Chunrong Zhong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Renjuan Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Xuezhen Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Yu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Chaoqun Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Li Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Qian Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Shangzhi Xu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Xi Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Ting Xiong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Weiye Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Qin Gao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Hongmin Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Yuanjue Wu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Miao Hong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Jiangyue Wu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Wenli Cui
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Xiating Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Weiming Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Lixia Lin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Huanzhuo Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Duan Gao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Nan Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - De Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Guofu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Xiaoyi Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Xu Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Meng Wu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Sen Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Xiyu Cao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Tianqi Tan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Menghan Tu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Jingrong Guo
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Wenqi Hu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Wenwen Zhu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Daxiang Xiao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Lin Gong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Huaqi Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Jin Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Siyu Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Mei Xiao
- Department of Obstetrics, Hubei Maternal and Child Health Hospital , Wuhan, China
- Department of Integrated Traditional and Western Medicine, Hubei Maternal and Child Health Hospital , Wuhan, China
| | - Guoqiang Sun
- Department of Obstetrics, Hubei Maternal and Child Health Hospital , Wuhan, China
- Department of Integrated Traditional and Western Medicine, Hubei Maternal and Child Health Hospital , Wuhan, China
| | - Guoping Xiong
- Department of Obstetrics and Gynecology, The Central Hospital of Wuhan , Wuhan, China
| | - Zemin Ni
- Jiang'an Maternal and Child Health Hospital , Wuhan, China
| | - Jing Wang
- Jiang'an Maternal and Child Health Hospital , Wuhan, China
| | - Zhichun Jin
- Department of Obstetrics, Hubei Maternal and Child Health Hospital , Wuhan, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Hongying Yang
- Institute of Health Education, Hubei Provincial Center for Disease Control and Prevention , Wuhan, China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
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8
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Wang R, Xu M, Yang W, Xie G, Yang L, Shang L, Zhang B, Guo L, Yue J, Zeng L, Chung MC. Maternal sleep during pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis. J Diabetes Investig 2022; 13:1262-1276. [PMID: 35171528 PMCID: PMC9248434 DOI: 10.1111/jdi.13770] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/26/2022] [Accepted: 02/11/2022] [Indexed: 11/28/2022] Open
Abstract
AIM/INTRODUCTION Sleep problem is an important public health concern worldwide. We conducted a meta-analysis to quantitatively evaluate whether sleep duration associated with pregnancy outcomes, and the associations were modified by important characteristics of studies. MATERIALS AND METHODS Basing on PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) databases, we searched for the published literature related to maternal sleep duration and adverse pregnancy outcomes before 30 June, 2021. We conducted risk of bias assessment, subgroup analyses and sensitivity analysis. The relative risks (RR) or odds ratios (OR) with 95% confidence intervals (CI) were used to estimate the pooled effects. RESULTS 5246 references were identified through databases searching, 41 studies were included in the study. Pregnant with short sleep duration had 1.81 times (95% CI 1.35-2.44, P < 0.001) risk of gestational diabetes mellitus (GDM). The association between short sleep duration and the risk of gestational hypertension (GH), cesarean section (CS), low birthweight (LBW), preterm birth (PTB) and small for gestational age (SGA) were not significant (P > 0.05). Furthermore, long sleep duration was significantly correlated with GDM (OR 1.24. 95% CI 1.12-1.36, P < 0.001) and CS (OR 1.13. 95% CI 1.04-1.22, P = 0.004), while long sleep duration was not linked with GH, LBW, PTB and SGA (P > 0.05). CONCLUSIONS Short / long sleep duration appeared to be associated with adverse pregnancy outcome, specifically with an increased risk of GDM. Sleep should be systematically screened in the obstetric population.
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Affiliation(s)
- Ruiqi Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Mengmeng Xu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Guilan Xie
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Liren Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Li Shang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China.,Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, P.R. China
| | - Boxing Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Leqian Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Maternal & Child Health Center, Xi'an, Shaanxi, P.R. China
| | - Jie Yue
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P.R. China
| | - Mei Chun Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Massachusetts Boston, United States of America
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9
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O’Brien LM. Sleep in Pregnancy. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Shi F, Ji C, Wu Q, Zhao Y. Association between sleep duration during pregnancy and preterm birth: a dose-response meta-analysis. J Matern Fetal Neonatal Med 2021; 35:7617-7628. [PMID: 34670468 DOI: 10.1080/14767058.2021.1957821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Preterm birth is now a global health problem. There is a great alteration of sleep duration in pregnancy. Whether sleep duration in pregnancy affects preterm birth remains unclarified. This study aimed to examine the associations of sleep duration on preterm birth risk based on the dose-response meta-analysis. MATERIALS AND METHODS Electronic databases (PubMed, Web of Science, and Ovid) were searched for relevant studies from database inception to September 2020. Studies describing the associations of maternal sleep duration with preterm birth risk were included. A random-effects model was adopted to calculate the summarized relative risk (SRR) and 95% confidence intervals (CIs) as the effect sizes for all studies. Moreover, dose-response analysis was used for combining studies that used categories of sleep duration as exposure. In addition, subgroup analysis and meta-regression analysis were conducted to adjust potential confounders and investigate the source of heterogeneity. RESULTS A total of 3771 unique studies were screened, and eight cohort studies and one case-control study were identified, with a total of 2000 preterm birth cases. Pooled data indicated that extreme sleep duration (short sleep duration or long sleep duration) in pregnancy was closely related to preterm birth in comparison with normal sleep duration (SRR = 1.13, 95%CI: 1.05-1.22) and there was no significant heterogeneity among studies (I2 = 7.0%, p = .37). Begg's funnel plot failed to uncover any evidence of publication bias. The non-linearity in the association of sleep duration with preterm birth showed significance (p < .01). Considering pregnant women slept for 7 h as a reference, 4 h short sleepers had a higher predicted risk of preterm birth (RR = 1.10, 95%CI: 1.01-1.19). Additionally, as compared with women with normal sleep duration, the preterm birth risk with short sleep durations (SRR = 1.20, 95%CI: 1.05-1.37) was elevated among pregnant women, and long sleep duration was related to preterm birth after adjusting for age (SRR = 1.20, 95%CI: 1.01-1.42). CONCLUSION There is an association of extreme sleep duration in pregnancy with preterm birth. In a non-linear dose-response meta-analysis, a U-shaped relationship between sleep duration and risk of preterm birth was observed and pregnant women who slept 4 h/day had a significantly higher risk of preterm birth than those who slept normally.
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Affiliation(s)
- Feng Shi
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Chao Ji
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
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11
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Marinelli M, Carsin AE, Turner MC, Fernández-Somoano A, Rodriguez-Dehli AC, Basterrechea M, Santa-Marina L, Iñiguez C, Lopez-Espinosa MJ, Sunyer J, Julvez J. Maternal sleep duration and neonate birth weight: A population-based cohort study. Int J Gynaecol Obstet 2021; 156:494-501. [PMID: 33754347 DOI: 10.1002/ijgo.13685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/17/2021] [Accepted: 03/21/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To investigate the association between maternal sleep duration (an important health indicator) and neonate birth weight. METHODS The study included 2536 mother-neonate pairs of a Spanish birth cohort (2004-2006, INMA project). The exposures were questionnaire-based measures of sleep duration before and during pregnancy. The primary outcome was neonate birth weight score (g) standardized to 40 weeks of gestation. RESULTS In women sleeping for <7 h/day before pregnancy, each additional hour of sleep increased birth weight score by 44.7 g (P = 0.049) in the minimally adjusted model, although findings were not statistically significant after considering other potential confounders (P > 0.05). However, increasing sleep duration for the group of mothers who slept for more than 9 h/day decreased birth weight score by 39.2 g per additional hour (P = 0.001). Findings were similar after adjusting for several sociodemographic confounders and maternal depression-anxiety clinical history as an intermediate factor. Similar but attenuated associations were observed with sleep duration in the second trimester of pregnancy. CONCLUSION The relationship between maternal sleep duration before and during pregnancy and neonate birth weight is an inverse U-shaped curve. Excessive sleep duration may adversely affect neonate health through its impact on birth weight.
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Affiliation(s)
- Marcella Marinelli
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Agència de Qualitat i Avaluació en Salut de Catalunya (AQuAS), Barcelona, Spain
| | - Anne-Elie Carsin
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,University of Oviedo, Oviedo, Spain
| | | | - Mikel Basterrechea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain.,Health Research Institute, Biodonostia, San Sebastián, Spain
| | - Loreto Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain.,Health Research Institute, Biodonostia, San Sebastián, Spain
| | - Carmen Iñiguez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,FISABIO-Universitat Jaume I-Universitat de València Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | - Jordi Sunyer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Jordi Julvez
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus, Spain
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12
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Lu Q, Zhang X, Wang Y, Li J, Xu Y, Song X, Su S, Zhu X, Vitiello MV, Shi J, Bao Y, Lu L. Sleep disturbances during pregnancy and adverse maternal and fetal outcomes: A systematic review and meta-analysis. Sleep Med Rev 2021; 58:101436. [PMID: 33571887 DOI: 10.1016/j.smrv.2021.101436] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022]
Abstract
Sleep disturbances are highly prevalent in pregnancy and are frequently overlooked as a potential cause of significant morbidity. The association between sleep disturbances and pregnancy outcomes remains largely controversial and needs to be clarified to guide management. To evaluate the association between sleep disturbances and maternal complications and adverse fetal outcomes, we performed a systematic search of PubMed, Embase and Web of Science for English-language articles published from inception to March 6, 2020, including observational studies of pregnant women with and without sleep disturbances assessing the risk of obstetric complications in the antenatal, intrapartum or postnatal period, and neonatal complications. Data extraction was completed independently by two reviewers. We utilized the Newcastle-Ottawa Scales to assess the methodological quality of included studies and random-effect models to pool the associations. A total of 120 studies with 58,123,250 pregnant women were included. Sleep disturbances were assessed, including poor sleep quality, extreme sleep duration, insomnia symptoms, restless legs syndrome, subjective sleep-disordered breathing and diagnosed obstructive sleep apnea. Significant associations were found between sleep disturbances in pregnancy and a variety of maternal complications and adverse fetal outcomes. Overall sleep disturbances were significantly associated with pre-eclampsia (odds ratio = 2.80, 95% confidence interval: 2.38-3.30), gestational hypertension (1.74, 1.54-1.97), gestational diabetes mellitus (1.59, 1.45-1.76), cesarean section (1.47, 1.31-1.64), preterm birth (1.38, 1.26-1.51), large for gestational age (1.40, 1.11-1.77), and stillbirth (1.25, 1.08-1.45), but not small for gestational age (1.03, 0.92-1.16), or low birth weight (1.27, 0.98-1.64). Sleep disturbances were related to higher morbidities in pregnant women who are 30 y or older and overweight before pregnancy. The findings indicate that sleep disturbances, which are easily ignored and treatable for both pregnant women and clinical services, deserve more attention from health care providers during prenatal counseling and health care services.
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Affiliation(s)
- Qingdong Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Xiaoyan Zhang
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yunhe Wang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Jinqiao Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Yingying Xu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Xiaohong Song
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Sizhen Su
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Ximei Zhu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China.
| | - Yanping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China.
| | - Lin Lu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China.
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13
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Li R, Zhang J, Gao Y, Zhang Y, Lan X, Dong H, Wu C, Yu C, Peng M, Zeng G. Duration and quality of sleep during pregnancy are associated with preterm birth and small for gestational age: A prospective study. Int J Gynaecol Obstet 2021; 155:505-511. [PMID: 33421108 DOI: 10.1002/ijgo.13584] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/30/2020] [Accepted: 01/06/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To explore the associations of duration and quality of sleep during pregnancy with preterm birth and small for gestational age (SGA). METHODS A prospective study was carried out on 1082 healthy women with singleton pregnancies from Chengdu, China. Self-report questionnaires, including duration and quality of sleep and other information, were administered at 8-12, 24-28, and 32-36 weeks of pregnancy. Data on gestational age and weight and length of the neonates were recorded after delivery. After controlling the potential confounders, a multivariable logistic regression model was performed to evaluate whether duration and quality of sleep were associated with preterm birth and SGA. RESULTS Participants with short duration of sleep during the third trimester were more likely to report preterm birth (odds ratio [OR] 2.16, 95% confidence interval [CI] 1.26-4.81) and SGA (OR 2.67, 95% CI 1.18-6.54). Participants with poor quality of sleep during the third trimester were at high risk for preterm birth (OR 2.26, 95% CI 1.29-5.84) and SGA (OR 2.08, 95% CI 1.19-5.38). CONCLUSION Short duration and poor quality of sleep during pregnancy are associated with an increased risk of preterm birth and SGA. Sleep characteristics should be assessed during prenatal evaluations to decrease adverse maternal and fetal outcomes.
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Affiliation(s)
- Run Li
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, China
| | - Ju Zhang
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, China
| | - Yan Gao
- Department of Obstetrics, Sichuan Provincial Hospital for Women and Children, Chengdu, China
| | - Yiqi Zhang
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xi Lan
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Hongli Dong
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Cheng Wu
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, China
| | - Chengwei Yu
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, China
| | - Min Peng
- Department of Clinical Nutrition, Sichuan Provincial Hospital for Women and Children, Chengdu, China
| | - Guo Zeng
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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14
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Abstract
PURPOSE OF REVIEW Sleep disturbances are increasing in prevalence in North America. There is growing evidence that poor sleep quality and short sleep duration may adversely affect circadian rhythms, which in turn may affect female reproduction. The objective of this review is to evaluate recent literature on the association between sleep disturbances and female reproduction. RECENT FINDINGS There is accumulating evidence that sleep quality and duration are important for female reproduction, but epidemiologic research is limited. Recent studies provide suggestive evidence that sleep disorders are associated with increased menstrual irregularity, subfertility/infertility, and poor pregnancy and birth outcomes. Mechanisms underlying these associations are likely to be multifactorial and complex. In addition to genetics, circadian disruption may impact reproductive outcomes through dysregulation of the hypothalamic-pituitary-adrenal axis, insulin resistance, oxidative stress, and systemic inflammation. Recommendations for future studies include: use of prospective study designs; assessment of populations not already experiencing reproductive disorders; more detailed and accurate assessments of sleep such as validated self-reported measures or objective sleep measures (e.g. actigraphy); comprehensive assessment of potential confounders and mediators; and elucidation of biologic mechanisms. SUMMARY There is a growing body of literature showing evidence that sleep disturbances influence female reproduction, although further epidemiologic research is needed.
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Affiliation(s)
- Sydney Kaye Willis
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
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15
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Zhang X, Zhang R, Cheng L, Wang Y, Ding X, Fu J, Dang J, Moore J, Li R. The effect of sleep impairment on gestational diabetes mellitus: a systematic review and meta-analysis of cohort studies. Sleep Med 2020; 74:267-277. [PMID: 32862011 DOI: 10.1016/j.sleep.2020.05.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/21/2019] [Accepted: 05/08/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis evaluated the influence of sleep duration or impairment (poor sleep quality, snoring, and obstructive sleep apnea [OSA]) on gestational diabetes mellitus (GDM) risk. METHODS PubMed, Embase, EBSCO, and WOS databases were searched up to March 4th, 2019. Cohort studies were included and relative risk (RR) with 95% confidence interval (CI) were used as the measure of effects. Heterogeneity was assessed by the Chi-squared and I2 tests. Subgroup analyses, sensitivity analysis, and dose-response analysis were performed. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS A total of 16 studies with 2,551,017 pregnant women and 142,103 GDM cases were included in this study. Both short and long sleep duration were associated with increased risk of GDM. There was a U-shaped relationship between sleep duration and GDM risk (P-nonlinearity < 0.001), and pregnant women with 8 h of sleep presented lower GDM risk. Poor sleep quality, snoring and OSA also increased the subsequent risk of GDM. CONCLUSIONS Pregnant women should be made aware of the benefits of proper sleep, and those with poor sleep quality, snoring, and OSA should be screened for GDM.
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Affiliation(s)
- Xinge Zhang
- School of Health Sciences, Wuhan University, Wuhan, 430071, China.
| | - Rui Zhang
- College of Life Sciences, South-Central University for Nationalities, Wuhan, 430074, China.
| | - Lei Cheng
- School of Health Sciences, Wuhan University, Wuhan, 430071, China.
| | - Yueqiao Wang
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, V5Z 4E8, Canada.
| | - Xiaoting Ding
- Maternal and Child Health Hospital of Hubei Province, Wuhan, 430071, China.
| | - Jialin Fu
- School of Health Sciences, Wuhan University, Wuhan, 430071, China.
| | - Jiajia Dang
- School of Health Sciences, Wuhan University, Wuhan, 430071, China.
| | - Justin Moore
- Department of Family & Community Medicine, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA; Department of Epidemiology & Prevention, Wake Forest School of Medicine, USA; Department of Implementation Science, Wake Forest School of Medicine, USA.
| | - Rui Li
- School of Health Sciences, Wuhan University, Wuhan, 430071, China.
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16
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Effect of nighttime sleep duration and midday napping in early pregnancy on gestational diabetes mellitus. Sleep Breath 2020; 25:487-492. [DOI: 10.1007/s11325-020-02076-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 12/14/2022]
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17
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Hong M, Xiong T, Huang J, Wu Y, Lin L, Zhang Z, Huang L, Gao D, Wang H, Kang C, Gao Q, Yang X, Yang N, Hao L. Association of vitamin D supplementation with respiratory tract infection in infants. MATERNAL AND CHILD NUTRITION 2020; 16:e12987. [PMID: 32141233 PMCID: PMC7296792 DOI: 10.1111/mcn.12987] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 02/03/2020] [Accepted: 02/18/2020] [Indexed: 02/06/2023]
Abstract
Vitamin D deficiency has been reported to be associated with respiratory tract infection (RTI). However, evidence regarding the effects of vitamin D supplementation on susceptibility of infants to RTI is limited. In this prospective birth cohort study, we examined whether vitamin D supplementation reduced RTI risk in 2,244 infants completing the follow‐up from birth to 6 months of age. The outcome endpoint was the first episode of paediatrician‐diagnosed RTI or 6 months of age when no RTI event occurred. Infants receiving vitamin D supplements at a daily dose of 400–600 IU from birth to the outcome endpoint were defined as vitamin D supplementation and divided into four groups according to the average frequency of supplementation: 0, 1–2, 3–4, and 5–7 days/week. We evaluated the relationship between vitamin D supplementation and time to the first episode of RTI with Kaplan–Meier plots. The associations of vitamin D supplementation with infant RTI, lower RTI (LRTI), and RTI‐related hospitalization were assessed using modified Poisson regression. The median time to first RTI episode was 60 days after birth (95% CI [60, 90]) for infants without supplementation and longer than 6 months of age for infants with supplementation (p < .001). We observed inverse trends between supplementation frequency and risk of RTI, LRTI, and RTI‐related hospitalization (p for trend < .001), with the risk ratios in the 5–7 days/week supplementation group of 0.46 (95% CI [0.41, 0.50]), 0.17 (95% CI [0.13, 0.24]), and 0.18 (95% CI [0.12, 0.27]), respectively. These associations were significant and consistent in a subgroup analysis stratified by infant feeding.
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Affiliation(s)
- Miao Hong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Xiong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junmei Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Clinical Nutrition, People's Hospital of Sanya City, Sanya, China
| | - Yuanjue Wu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lixia Lin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Zhang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Huang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Duan Gao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huanzhuo Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chun Kang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qin Gao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuefeng Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nianhong Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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18
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Feinstein L, McWhorter KL, Gaston SA, Troxel WM, Sharkey KM, Jackson CL. Racial/ethnic disparities in sleep duration and sleep disturbances among pregnant and non-pregnant women in the United States. J Sleep Res 2020; 29:e13000. [PMID: 32112620 DOI: 10.1111/jsr.13000] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/17/2020] [Accepted: 01/27/2020] [Indexed: 12/24/2022]
Abstract
Sleep disturbances among pregnant women are increasingly linked to suboptimal maternal/birth outcomes. Few studies in the USA investigating sleep by pregnancy status have included racially/ethnically diverse populations, despite worsening disparities in adverse birth outcomes. Using a nationally representative sample of 71,644 (2,349 pregnant) women from the National Health Interview Survey (2004-2017), we investigated relationships between self-reported pregnancy and six sleep characteristics stratified by race/ethnicity. We also examined associations between race/ethnicity and sleep stratified by pregnancy status. We used average marginal predictions from fitted logistic regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each sleep dimension, adjusting for sociodemographic and health characteristics. Pregnant women were less likely than non-pregnant women to report short sleep (PROverall = 0.75; 95% CI, 0.68-0.82) and more likely to report long sleep (PROverall = 2.06; 95% CI, 1.74-2.43) and trouble staying asleep (PROverall = 1.34; 95% CI, 1.25-1.44). The association between pregnancy and sleep duration was less pronounced among women aged 35-49 years compared to those <35 years. Among white women, sleep medication use was less prevalent among pregnant compared to non-pregnant women (PRWhite = 0.45; 95% CI, 0.31-0.64), but this association was not observed among black women (PRBlack = 0.98; 95% CI, 0.46-2.09) and was less pronounced among Hispanic/Latina women (PRHispanic/Latina = 0.82; 95% CI, 0.38-1.77). Compared to pregnant white women, pregnant black women had a higher short sleep prevalence (PRBlack = 1.35; 95% CI, 1.08-1.67). Given disparities in maternal/birth outcomes and sleep, expectant mothers (particularly racial/ethnic minorities) may need screening followed by treatment for sleep disturbances. Our findings should be interpreted in the historical and sociocultural context of the USA.
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Affiliation(s)
- Lydia Feinstein
- Social and Scientific Systems, Durham, NC, USA.,Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ketrell L McWhorter
- School of Science, Health and Mathematics, Asbury University, Wilmore, KY, USA
| | - Symielle A Gaston
- Epidemiology Branch, Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Wendy M Troxel
- Behavioral and Social Sciences, RAND Corporation, Pittsburgh, PA, USA
| | - Katherine M Sharkey
- Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, RI, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Chandra L Jackson
- Epidemiology Branch, Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.,Intramural Program, Department of Health and Human Services, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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19
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Tan L, Zou J, Zhang Y, Yang Q, Shi H. A Longitudinal Study of Physical Activity to Improve Sleep Quality During Pregnancy. Nat Sci Sleep 2020; 12:431-442. [PMID: 32765140 PMCID: PMC7367923 DOI: 10.2147/nss.s253213] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/17/2020] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To explore the association between maternal physical activity (PA) and sleep quality during pregnancy, and the necessary PA level at different gestational stages to attain improved sleep quality. METHODS A total of 2443 participants were recruited from the Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC) study, who had completed questionnaires including the Pittsburgh Sleep Quality Index (PSQI) and the International Physical Activity Questionnaire (IPAQ) at gestational weeks (GW) of 12-16 and 32-36. PSQI scores and their seven components at the two GW were compared, as were PSQI scores at 12-16 and 32-36 GW and the increment in PSQI relative to PA. Regression analysis was conducted to assess the effect of PA and its change on the total PSQI score at different GW. RESULTS The mean PSQI scores increased significantly during pregnancy, from 6.30 ± 3.01 at 12-16 GW to 7.23 ± 3.47 at 32-36 GW. Compared with women in low PA level, moderate levels of PA at both 12-16 GW and 32-36 GW were significantly reduced PSQI scores of 0.42 (95% CI:-0.68,-0.16) and 0.32 (95% CI:-0.63,-0.01), respectively. At 32-36 GW, high PA level also significantly decreased PSQI score, with a greater decline than moderate PA level. (AOR=-0.87,95% CI:-1.57,-0.18). PA increment from 12-16 to 32-36 weeks of pregnancy created a significant decline of 0.54 in PSQI scores. CONCLUSION The study revealed sleep quality was worse at the third trimester and moderate PA level had the potential for improvement of sleep quality both in the first and the third trimester. High PA level was also beneficial to improve sleep quality of pregnant women in the third trimester.
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Affiliation(s)
- Liwei Tan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Jiaojiao Zou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Yunhui Zhang
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Qing Yang
- Department of Child Care, The Maternal and Child Healthcare Institute of Songjiang District, Shanghai, People's Republic of China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, People's Republic of China
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Abstract
Pregnancy is associated with a number of physiologic changes in the body including hormonal, anatomical, and mechanical. These changes alter many physiologic functions including sleep. The literature suggests that a number of women develop changes in duration, pattern, and quality of sleep during pregnancy. In addition, these changes also pave the way for expression of sleep disorders (e.g., insomnia, obstructive sleep apnea, and restless legs syndrome). Change in sleep and appearance of sleep disorders not only influence pregnant women, but also have negative influences on the fetus and outcomes of pregnancy. However, optimal management of these disorders may reverse adverse consequences. In this chapter, risk factors, clinical presentation, and management of insomnia, obstructive sleep apnea, and restless legs syndrome during pregnancy are discussed in view of the available literature.
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Affiliation(s)
- Ravi Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, India.
| | - Vikram Singh Rawat
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, India
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21
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Liu B, Song L, Zhang L, Wang L, Wu M, Xu S, Wang Y. Sleep patterns and the risk of adverse birth outcomes among Chinese women. Int J Gynaecol Obstet 2019; 146:308-314. [DOI: 10.1002/ijgo.12878] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 01/30/2019] [Accepted: 05/31/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Bingqing Liu
- Department of Maternal and Child HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Lulu Song
- Department of Maternal and Child HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Lina Zhang
- Department of Maternal and Child HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Lulin Wang
- Department of Maternal and Child HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Mingyang Wu
- Department of Maternal and Child HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Shunqing Xu
- Key Laboratory of Environment and HealthMinistry of Education & Ministry of Environmental ProtectionHuazhong University of Science and Technology Wuhan China
- State Key Laboratory of Environmental HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
| | - Youjie Wang
- Department of Maternal and Child HealthSchool of Public HealthTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
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22
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Warland J, Dorrian J, Morrison JL, O'Brien LM. Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis. Sleep Med Rev 2018; 41:197-219. [DOI: 10.1016/j.smrv.2018.03.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/14/2018] [Accepted: 03/20/2018] [Indexed: 01/15/2023]
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23
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Xu YH, Shi L, Bao YP, Chen SJ, Shi J, Zhang RL, Lu L. Association between sleep duration during pregnancy and gestational diabetes mellitus: a meta-analysis. Sleep Med 2018; 52:67-74. [PMID: 30286382 DOI: 10.1016/j.sleep.2018.07.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Sleep is critical for glucose metabolism. Pregnant women often have sleep disturbances and extreme sleep duration. Investigations of the relationship between sleep duration during pregnancy and gestational diabetes mellitus (GDM) have reported inconsistent results. The present study aimed to meta-analyze the relationship between sleep duration during pregnancy and GDM risk. METHODS We performed a systematic search of the PubMed, ISI Web of Science, and PsycINFO databases for studies that were published up to October 2017, that reported associations between sleep duration during pregnancy and GDM risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as the effect sizes for all studies. Heterogeneity and potential publication biases were assessed. RESULTS A total of 4366 papers were retrieved, among which seven studies assessed the relationship between sleep duration during pregnancy and GDM development. The seven articles included 18,203 subjects at baseline and 1294 GDM cases during follow-up. Compared to normal sleep duration, extreme sleep duration during early and middle pregnant stages had a close relationship with GDM based upon pooled data from prospective and cross-sectional studies. Prospective results showed that long sleep duration during pregnancy was a risk factor for GDM, but not short sleep duration. Publication biases were found when analyzing the relationship between extreme sleep duration and GDM. CONCLUSIONS Extreme sleep duration during pregnancy is closely associated with GDM. Moreover, long but not short sleep duration can predict the risk of developing GDM. These findings remind us of the importance of sleep duration control during pregnancy and help optimize early strategies for the prevention of GDM.
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Affiliation(s)
- Ya-Hui Xu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; National Institute on Drug Dependence, Peking University, Beijing, China; Department of Addiction, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; National Institute on Drug Dependence, Peking University, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Si-Jing Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Rui-Ling Zhang
- Department of Addiction, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; National Institute on Drug Dependence, Peking University, Beijing, China; Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China; PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.
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