Prior pregnancy loss and sleep experience during subsequent pregnancy

To describe sleep characteristics in the third trimester of pregnancy for women who had a prior pregnancy loss compared to women with no history of loss.

Descriptive comparison of baseline data prior to randomization for a clinical trial.

Participants' homes.

Eligible women recruited from childbirth education classes during third trimester were over 18 years old, in partnered relationships, spoke English, did not work nightshift or have a diagnosed sleep disorder, and had no current complications or prior pregnancy loss (n = 140). Women with prior miscarriage or stillbirth were offered enrollment in an ancillary study (n = 20).

Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI) and wrist actigraphy. Other measures included relationship satisfaction, perceived stress, and depressive symptoms. For this analysis, only third trimester data prior to randomization were compared.

Both groups had similar actigraphy-recorded sleep duration (7.1 ± 1.1 hours) and sleep efficiency (83.7 ± 7.9%). However, the pregnancy loss group had significantly (p = .050) worse PSQI scores (7.8 ± 2.6) than controls (6.7 ± 3.1), resulting primarily from the sleep disturbance component (p = .003), specifically bad dreams (p = .030) and legs twitching/jerking (p = .071). Controlling for demographic and health factors in multivariate analyses, prior pregnancy loss was significant for sleep disturbance (p = .047), bad dreams (p = .018), and partner-reported leg twitching/jerking (p = .048).

Long after the acute grief of a pregnancy loss, perceived sleep quality can be problematic during the next pregnancy. Whether poor sleep quality is present prior to the pregnancy loss or reflects long-term maternal sleep characteristics require further research.