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Gestational age at birth and sleep duration in early childhood in three population-based cohorts
Maartje P C M Luijk1,2, Desana Kocevska2,3, Elaine K H Tham4
1Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, the Netherlands.
Insights
Infants born earlier or later than full term may experience altered sleep patterns. Lower gestational age at birth is linked to longer sleep duration in early childhood, highlighting sleep's role in neurodevelopment.
Area of Science:
- Neonatal development
- Pediatric sleep science
- Perinatal epidemiology
Background:
- Preterm and post-term births are linked to neonatal health issues and neurodevelopmental impacts.
- Sleep is crucial for neural maturation in newborns, but research on gestational age and early childhood sleep is inconsistent.
- Previous studies often used small clinical samples, necessitating larger population-based investigations.
Purpose of the Study:
- To investigate the association between gestational age at birth and sleep duration in early childhood.
- To analyze data from multiple large, population-based cohorts to provide robust findings.
- To clarify the relationship between variations in gestational duration and infant sleep patterns.
Main Methods:
- Utilized three population-based cohorts from the Netherlands, Singapore, and Canada.
- Assessed gestational age via ultrasound and date of birth; collected caregiver-reported sleep duration at 3, 6, 24, and 36 months.
- Employed generalized estimating equations adjusted for confounders and conducted a meta-analysis for pooled results.
Main Results:
- Children born preterm (<37 weeks gestation) exhibited longer sleep durations compared to term-born infants.
- Post-term infants (≥42 weeks gestation) demonstrated shorter sleep durations.
- Meta-analysis revealed a slight negative effect of gestational age on sleep duration in term-born children (-0.11 effect size).
Conclusions:
- Lower gestational age at birth correlates with longer sleep duration in early childhood, even for infants born within the term range (37-42 weeks).
- These findings underscore the significance of sleep-related maturational processes for both preterm infants and those born at term following shorter gestational durations.
- Subtle but consistent associations suggest gestational age is an important factor influencing early childhood sleep patterns and neurodevelopment.
Background:
Both preterm and post-term births have been associated with neonatal morbidity and mortality, including adverse impact on neurodevelopment. Important neural maturational processes take place during sleep in newborns, but findings on gestational duration and sleep in early childhood are contradictory and often derive from small clinical samples. We studied the association of gestational age at birth with sleep duration in early childhood in three population-based cohorts.
Methods:
Gestational age at birth and sleep duration were assessed in three population-based cohort studies in The Netherlands (n = 6471), Singapore (n = 862), and Canada (n = 583). Gestational age at birth was assessed using ultrasound in pregnancy in combination with date of birth, and caregivers repeatedly reported on child sleep duration at three, six, 24, and 36 months of age. Generalized estimating equations were used, which were adjusted for confounders, and findings were pooled in a meta-analysis.
Results:
Children born preterm (<37 weeks of gestation) showed longer sleep duration than children born at term; and children born post-term (≥42 weeks of gestation) showed shorter sleep duration. The meta-analysis indicated a small negative effect of gestational age on child sleep duration (effect size -0.11), when assessed in children born at term only.
Conclusion:
In early childhood, children with a lower gestational age have a longer sleep duration, even when they are born at term (37-42 weeks of gestation). These subtle yet consistent findings point to the importance of maturational processes during sleep, not only in premature children but also in children born at term after shorter gestational duration.
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