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Sleep patterns and sleep disorders in pregnant women with preeclampsia: a systematic review and meta-analysis
Rebeca Lundii Oliveira Pereira1, Naila Giovana Ferraz de Oliveira1, Celia Regina Santos Cavalcanti1
1Universidade Federal de São Paulo Escola Paulista de Medicina São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Objective:
Preeclampsia (PE) is a hypertensive disorder of pregnancy with diverse and poorly understood risk factors. Hormonal changes during this period affect sleep, raising the question of whether sleep disturbances may be related to PE. This review aimed to investigate the prevalence of sleep disturbances among pregnant women diagnosed with PE.
Methods:
We included observational studies and clinical trials assessing sleep by any method. Exclusion criteria were studies on PE without sleep assessment, systematic reviews, editorials, animal studies, and unavailable full texts. Studies were retrieved from Virtual Health Library, MEDLINE and Embase using the descriptors "preeclampsia" and "sleep" with additional manual searches. The last search was conducted on December 10, 2024. Screening and data extraction were performed independently by two reviewers. Risk of bias was assessed using the Joanna Briggs Institute checklist. Random-effects models were used to synthesize prevalence as proportions with 95% confidence intervals (CIs).
Results:
Twenty-one studies were included from 2,075 initially identified. The pooled prevalence of sleep disturbances in PE was 46% (95% CI [0,19 - 0,76]), p=0,823. Stratified analysis identified two categories: qualitative disturbances, with prevalence of 50% (95% CI [0.31-0.70]); and sleep-disordered breathing with prevalence of 43% (95% CI [0.10-0.83]).
Discussion:
This meta-analysis found an estimated 46% prevalence of sleep disturbances in preeclampsia; however, the evidence is of very low quality (GRADE), due to extreme heterogeneity and uncontrolled risk of bias.PROSPERO: CRD42024557766.
