Being Born Too Small and Too Early May Alter Sleep in Childhood

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Sleep Medicine

Background:

• Fetal growth restriction (FGR) affects up to 10% of pregnancies, increasing risks for prematurity and neurodevelopmental issues.
• FGR is known to alter in utero sleep states and infant maturation, but long-term childhood sleep associations are understudied.
• Sleep disturbances in childhood can negatively impact behavior and neurodevelopment.

Purpose of the Study:

• To investigate the long-term associations between preterm birth, FGR, and sleep architecture in children aged 5-12 years.
• To compare sleep macro- and microarchitecture in children born preterm with FGR, preterm without FGR, and term-born controls.

Main Methods:

• Overnight polysomnography was conducted on three groups: preterm FGR (n=17), preterm appropriate birth weight for gestational age (AGA) (n=15), and term AGA (controls, n=20).
• Sleep macroarchitecture was analyzed using standard criteria.
• Sleep microarchitecture was assessed via spectral analysis of the electroencephalogram (C4-M1), calculating total, δ, θ, α, σ, and β power.

Main Results:

• Preterm FGR children showed increased N2 sleep percentage compared to term AGA controls.
• Preterm AGA children had reduced total sleep time, NREM%, and sleep efficiency versus term AGA controls.
• Preterm FGR children exhibited higher total, δ, and α power, while preterm AGA children had the lowest σ and β power compared to controls.

Conclusions:

• Both prematurity and FGR are linked to significant alterations in childhood sleep macro- and microarchitecture.
• These sleep alterations suggest reduced sleep quantity and quality in children with a history of FGR and/or preterm birth.
• Further investigation into sleep disturbances in FGR and preterm populations is warranted due to potential impacts on neurodevelopment and behavior.