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Association of Maternal Short Sleep Duration With Neurodevelopmental Delay in Offspring: A Prospective Cohort Study
Lei Zhang1,2,3,4, Hai-Xia Wang1,2,3,4, Wen-Xiang Li1
1Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China.
Insights
Short sleep duration in pregnancy is linked to neurodevelopmental delays in male offspring. This association may be partly explained by higher cord C-peptide levels, impacting child development.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Developmental Psychology
Background:
- Short sleep duration (SSD) during pregnancy is a growing concern for maternal health and child development.
- Understanding the impact of maternal sleep on offspring neurodevelopment is crucial for establishing effective pregnancy guidelines.
Purpose of the Study:
- To investigate the association between maternal short sleep duration (SSD) during pregnancy and neurodevelopmental delays in offspring.
- To explore the potential role of fetal glucose metabolism, indicated by cord blood C-peptide levels, in mediating this relationship.
Main Methods:
- A cohort study of 7059 mother-child pairs from the Maternal & Infants Health in Hefei cohort.
- Maternal sleep assessed using the Pittsburgh Sleep Quality Index; offspring neurodevelopment evaluated using the Denver Developmental Screening Test-II and Gesell Development Diagnosis Scale.
- Cox proportional hazard regression and mediation analysis were employed to analyze the data.
Main Results:
- Maternal SSD during mid-pregnancy was significantly associated with an increased risk of neurodevelopmental delay in male offspring (aHR 2.05).
- Higher cord blood serum C-peptide levels were positively related to offspring neurodevelopmental delay (RR 0.04).
- Cord blood C-peptide levels mediated approximately 11.05% of the association between maternal SSD and offspring neurodevelopmental delay.
Conclusions:
- Maternal short sleep duration during pregnancy is linked to an increased incidence of offspring neurodevelopmental delay, with notable sex differences.
- Elevated cord C-peptide levels may partially mediate the relationship between maternal sleep duration and neurodevelopmental outcomes in children.
Context:
To investigate how short sleep duration (SSD) during pregnancy is related to neurodevelopmental delays in offspring, we aimed to inform pregnancy sleep guidelines and promote maternal health and child development.
Objective:
To identify the associations between SSD during pregnancy and offspring neurodevelopmental delay and to determine whether fetal glucose metabolism plays a role in SSD and neurodevelopmental delays.
Methods:
This cohort study followed 7059 mother-child pairs from the Maternal & Infants Health in Hefei cohort, and collected sleep data during pregnancy via the Pittsburgh Sleep Quality Index at weeks 24 to 28 and 32 to 36. Neurodevelopmental outcomes from 6 to 36 months postpartum were assessed via the Denver Developmental Screening Test-II and the Gesell Development Diagnosis Scale. Cox proportional hazard regression was used to analyze the link between maternal SSD and neurodevelopmental delay risk. Mediation analysis was used to evaluate the role of cord blood serum C-peptide levels. Three hospitals and children's health centers in Hefei were involved.
Results:
The stratified analysis revealed a significant association between mothers with SSD during midpregnancy and neurodevelopmental delay in boys (adjusted HR 2.05, 95% CI 1.29, 3.25). Cord blood marker analysis revealed a positive relationship between cord blood serum C-peptide levels and neurodevelopmental delay in offspring (RR 0.04, 95% CI 0.00, 0.08). The proportion of the association between SSD and neurodevelopmental delay mediated by cord blood C-peptide was 11.05%.
Conclusion:
Maternal SSD during pregnancy was continuously associated with an increased incidence of neurodevelopmental delay with sex differences among offspring. This association may be mediated in part by increased higher levels of cord C-peptide.
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