Poor sleep quality is associated with preterm birth

Area of Science:

• Obstetrics and Gynecology
• Sleep Medicine
• Public Health

Background:

• Preterm birth (PTB) is a significant global health concern and the leading cause of adverse pregnancy outcomes.
• While several risk factors for PTB are known, the precise etiological pathways remain incompletely understood.
• Poor sleep quality is recognized as a correlate of various adverse health conditions.

Purpose of the Study:

• To investigate whether sleep quality during pregnancy serves as a clinically relevant risk factor for preterm birth.
• To assess the association between self-reported sleep quality and the incidence of PTB.

Main Methods:

• An observational study involving 166 pregnant women.
• Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) via self-report questionnaires at multiple gestational points (14-16, 24-26, and 30-32 weeks).
• Logistic regression models were employed to analyze the relationship between sleep quality metrics and PTB.

Main Results:

• Poor sleep quality emerged as a significant predictor of preterm birth.
• The association between poor sleep and PTB was strongest in early pregnancy (14-16 weeks), with an odds ratio (OR) of 1.25 (95% CI [1.04-1.50], P = 0.02).
• A more modest, though still notable, association was found in late pregnancy (30-32 weeks) (OR: 1.18 95% CI [0.98-1.42], P = 0.07). Each one-point increase in PSQI score correlated with a 25% increase in PTB odds in early pregnancy and an 18% increase in later pregnancy.

Conclusions:

• Poor sleep quality during both early and late pregnancy is associated with an elevated risk of preterm delivery.
• The specific mechanisms by which disturbed sleep influences PTB are yet to be elucidated.
• It is hypothesized that poor sleep may independently contribute to PTB risk or act synergistically with other known risk factors like stress.