Maternal Sleep Disorders and Maternal and Birth Outcomes: A Retrospective US Claims-Based Study

Area of Science:

• Obstetrics and Gynecology
• Sleep Medicine
• Public Health

Background:

• Sleep disturbances are common in pregnancy, with potential adverse maternal, fetal, and neonatal outcomes.
• Self-reported sleep issues may not align with clinically diagnosed sleep disorder prevalence.
• Understanding diagnosed sleep disorders in pregnancy is crucial for maternal and infant health.

Purpose of the Study:

• To determine the prevalence of clinically diagnosed sleep disorders and breathing abnormalities in pregnant women.
• To examine associations between these sleep conditions and maternal health outcomes.
• To investigate the relationship between sleep disorders and birth outcomes.

Main Methods:

• Cross-sectional study of 93,767 pregnant women using Optum's Clinformatics Data Mart Database (2015-2021).
• Sleep disorders and breathing abnormalities identified via ICD-9/ICD-10 codes.
• Multivariable logistic regression models adjusted for demographic, insurance, infant sex, and pregnancy complication factors.

Main Results:

• Prevalence of clinically diagnosed sleep disorders and breathing abnormalities was 3.41%.
• These conditions were significantly associated with increased odds of cesarean delivery, gestational diabetes, gestational hypertension, preeclampsia, and postpartum depression.
• Associations were also found with stillbirths, newborn size, birthweight, and gestation period.

Conclusions:

• The low prevalence of clinical diagnoses suggests potential underdiagnosis of sleep disorders during pregnancy.
• Routine sleep screenings in prenatal care are recommended for early detection and management.
• Further research in diverse populations is needed to guide equitable screening strategies.