Factors Affecting Sleep Quality in Pregnant Women During the Second Trimester and Its Association with Birth Outcomes

To evaluate the sleep quality of pregnant women in mid-pregnancy in Wuhan study and analyze its association with birth outcomes in a cross-sectional study.

The sleep quality of 2210 pregnant women in the second trimester from Wuhan were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Dietary quality and prenatal depression were assessed by the dietary variety score (DVS) and the Edinburgh Postnatal Depression Scale (EPDS), respectively. Birth outcomes were retrieved from the Maternal and Child Health Information System. Principal component analysis, stratified analysis, and binary Logistic regression were used for statistical analysis.

Among the 2210 pregnant women, the prevalence of sleep disturbance during the second trimester was 18.14%. After adjusting for confounding factors, a EPDS score ≥ 11, pre-pregnancy alcohol consumption, and moderate to severe vomiting during pregnancy were risk factors for sleep disturbance; while a DVS score ≥ 28 points and exercise during pregnancy were protective factors for sleep disturbance. Sleep disturbance were significantly associated with a reduced risk of large for gestational age (LGA) (OR = 0.65, 95% CI: 0.45-0.94, P = 0.023), macrosomia (OR = 0.34, 95% CI: 0.13-0.86, P = 0.023), and a marginal association with an increased risk of preterm birth (PTB) (OR = 1.51, 95% CI: 0.97-2.35, P = 0.065), but stratified interaction analysis showed that sleep disturbance increased the risk of PTB, low birth weight, small for gestational age and small vulnerable neonates in mothers with pre-pregnancy BMI ≥ 24 kg/m² or delivering a male fetus.

Clinically, it is crucial to enhance sleep quality screening during the second trimester and provide targeted interventions for high-risk groups to improve maternal and infant outcomes.