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Volume 14 No. 12
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Accepted Papers





Scientific Investigations

Association of Adverse Pregnancy Outcomes With Self-Reported Measures of Sleep Duration and Timing in Women Who Are Nulliparous

Francesca L. Facco, MD1; Corette B. Parker, PhD2; Shannon Hunter, MS2; Kathryn J. Reid, PhD3; Phyllis C. Zee, MD, PhD3; Robert M. Silver, MD4; David M. Haas, MD5; Judith H. Chung, MD6; Grace W. Pien, MD7; Chia-Ling Nhan-Chang, MD, PhD8; Hyagriv N. Simhan, MD1; Samuel Parry, MD9; Ronald J. Wapner, MD8; George R. Saade, MD10; Brian M. Mercer, MD11; Caroline Torres, MD8; Jordan Knight, DO5; Uma M. Reddy, MD12; William A. Grobman, MD13
1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; 2RTI International, Research Triangle Park, North Carolina; 3Department of Neurology, Northwestern University, Chicago, Illinois; 4Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, Utah; 5Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, Indiana; 6Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California; 7Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland; 8Department of Obstetrics and Gynecology, Columbia University, New York, New York; 9Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania; 10Department of Obstetrics and Gynecology, University of Texas Medical Branch, University of Texas, Galveston, Texas; 11Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, Ohio; 12Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; 13Department of Obstetrics and Gynecology Medicine, Northwestern University, Chicago, Illinois

Study Objectives:

To examine the relationship of self-reported sleep during pregnancy with adverse pregnancy outcomes. A secondary objective was to describe the concordance between self-reported and objectively assessed sleep during pregnancy.

Methods:

In this prospective cohort, women completed a survey of sleep patterns at 6 to 13 weeks' gestation (visit 1) and again at 22 to 29 weeks' gestation (visit 3). Additionally, at 16 to 21 weeks (visit 2), a subgroup completed a week-long sleep diary coincident with an actigraphy recording. Weekly averages of self-reported sleep duration and sleep midpoint were calculated. A priori, sleep duration < 7 hours was defined as “short,” and sleep midpoint after 5:00 AM was defined as “late.” The relationship of these sleep abnormalities with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) was determined.

Results:

Of the 10,038 women enrolled, sleep survey data were available for 7,524 women at visit 1 and 7,668 women at visit 3. A total of 752 women also provided ≥ 5 days of sleep diary data coincident with actigraphy at visit 2. We did not observe any consistent relationship between self-reported short sleep and HDP or GDM. There was an association between self-reported late sleep midpoint and GDM (visit 1 adjusted odds ratio 1.67, 95% confidence interval 1.17, 2.38; visit 2 adjusted odds ratio 1.73, 95% confidence interval 1.23, 2.43). At visit 2, 77.1% of participants had concordance between their diary and actigraphy for short sleep duration, whereas 94.3% were concordant for sleep midpoint.

Conclusions:

Self-reported sleep midpoint, which is more accurate than self-reported sleep duration, is associated with the risk of GDM.

Clinical Trial Registration:

Registry: ClinicalTrials.gov, Title: Pregnancy as a Window to Future Cardiovascular Health: Adverse Pregnancy Outcomes as Predictors of Increased Risk Factors for Cardiovascular Disease, Identifier: NCT02231398, URL: https://clinicaltrials.gov/ct2/show/NCT02231398

Citation:

Facco FL, Parker CB, Hunter S, Reid KJ, Zee PC, Silver RM, Haas DM, Chung JH, Pien GW, Nhan-Chang CL, Simhan HN, Parry S, Wapner RJ, Saade GR, Mercer BM, Torres C, Knight J, Reddy UM, Grobman WA. Association of adverse pregnancy outcomes with self-reported measures of sleep duration and timing in women who are nulliparous. J Clin Sleep Med. 2018;14(12):2047–2056.


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