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[Association between sleep status in the first trimester and preterm birth]
1Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
Insights
Poor sleep quality in early pregnancy significantly increases the risk of preterm birth. This study highlights the importance of monitoring sleep patterns during the first trimester for better pregnancy outcomes.
Area of Science:
- Obstetrics and Gynecology
- Sleep Medicine
- Perinatal Health
Background:
- First-trimester sleep quality is crucial for pregnancy outcomes.
- Preterm birth remains a significant concern in perinatal health.
- Understanding early pregnancy risk factors is essential for timely intervention.
Purpose of the Study:
- To investigate the association between first-trimester sleep status and the incidence of preterm birth.
- To identify specific sleep parameters that correlate with increased preterm birth risk.
- To analyze the relationship between sleep quality and spontaneous preterm birth.
Main Methods:
- A cohort study involving pregnant women from September 2019 to June 2020.
- Utilized the Pittsburgh Sleep Quality Index (PSQI) to assess sleep status at 8-12 weeks of gestation.
- Categorized delivery outcomes into full-term, preterm birth, and spontaneous preterm birth groups for comparative analysis.
Main Results:
- Higher PSQI scores (indicating poorer sleep quality) were significantly associated with preterm birth and spontaneous preterm birth.
- Pregnant women experiencing poor sleep (PSQI > 7) had a higher risk of preterm delivery.
- Reduced nighttime sleep duration was observed in preterm birth groups compared to the full-term group.
- First-trimester PSQI score was identified as an independent risk factor for preterm birth (aOR=1.22).
- Assisted reproductive technology, gestational diabetes mellitus, and first-trimester PSQI score were independent risk factors for spontaneous preterm birth.
Conclusions:
- Decreased sleep quality during the first trimester is a significant risk factor for preterm birth.
- Monitoring and addressing sleep disturbances in early pregnancy may help mitigate the risk of preterm delivery.
- Further research is warranted to explore interventions for improving sleep quality in pregnant individuals.
Abstract:
Objective: To investigate the relationship between sleep status in the first trimester and preterm birth. Methods: Clinical data of pregnant women who received regular prenatal examination and delivered in Peking University Third Hospital from September 1, 2019 to June 10, 2020 were collected. The Pittsburgh sleep quality index (PSQI) was used to investigate their sleep status during 8-12 weeks of gestation, and the delivery outcomes were followed up. According to the gestational age at delivery and the cause of preterm birth, they were divided into full-term delivery group (204 cases), preterm birth group (13 cases) and spontaneous preterm birth group (9 cases). The correlation between the sleep status in the first trimester and preterm birth or spontaneous preterm birth was analyzed. Results: The median PSQI score of full-term delivery group was 4.0 points (3.0, 6.0 points), which was lower than those of preterm delivery group [6.0 points (4.0, 8.0 points)] and spontaneous preterm delivery group [7.0 points (4.0, 8.0 points)], and the differences were statistically significant (all P<0.05). The proportion of pregnant women with poor sleep quality (PSQI score>7 points) in full-term delivery group [14.2% (29/204)] was lower than those in preterm delivery group (5/13) and spontaneous preterm delivery group (4/9), and the differences were statistically significant (all P<0.05). Compared with the full-term delivery group [8.0 hours (7.0, 9.0 hours)], the preterm birth group [7.0 hours (7.0, 8.0 hours)] and spontaneous preterm birth group [7.0 hours (7.0, 8.0 hours)] had significantly shorter sleep duration at night (all P<0.05). Multivariate analysis showed that PSQI score in the first trimester was an independent risk factor for preterm birth (aOR=1.22, 95%CI: 1.02-1.45; P=0.026). Pregnancy with assisted reproductive technology (aOR=5.55, 95%CI: 1.22-25.31; P=0.027), gestational diabetes mellitus (aOR=9.27, 95%CI: 1.96-43.82; P=0.005), PSQI score in the first trimester (aOR=1.27, 95%CI: 1.01-1.58; P=0.039) were independent risk factors for spontaneous preterm birth. Conclusion: Attention should be paid to the decreased sleep quality in the first trimester, which might significantly increase the risk of preterm birth and spontaneous preterm birth.
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