Department of Reproductive Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-NUS Medical School, 8 College Road, 169857, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
Programme in Health Services & Systems Research and Center for Quantitative Medicine, Duke-NUS Medical School, 8 College Road, 169857, Singapore; Center for Child Health Research, Tampere University, Arvo Ylpönkatu 34 (ARVO B235), 33014 Tampere, Finland.
Clin Nutr. 2020 Jun;39(6):1935-1942. doi: 10.1016/j.clnu.2019.08.018. Epub 2019 Aug 26.
BACKGROUND & AIMS: Maternal metabolic disturbance arising from inappropriate meal timing or sleep deprivation may disrupt circadian rhythm, potentially inducing pregnancy complications. We examined the associations of maternal night-time eating and sleep duration during pregnancy with gestation length and preterm birth.
We studied 673 pregnant women from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Maternal energy intake by time of day and nightly sleep duration were assessed at 26-28 weeks' gestation. Based on 24-h dietary recall, night-eating was defined as consuming >50% of total energy intake from 1900 to 0659 h. Short sleep duration was defined as <6 h night sleep. Night-eating and short sleep were simultaneously analyzed to examine for associations with a) gestation length using multiple linear regression, and b) preterm birth (<37 weeks' gestation) using logistic regression.
Overall, 15.6% women engaged in night-eating, 12.3% had short sleep and 6.8% delivered preterm. Adjusting for confounding factors, night-eating was associated with 0.45 weeks shortening of gestation length (95% CI -0.75, -0.16) and 2.19-fold higher odds of delivering preterm (1.01, 4.72). Short sleep was associated with 0.33 weeks shortening of gestation length (-0.66, -0.01), but its association with preterm birth did not reach statistical significance (1.81; 0.76, 4.30).
During pregnancy, women with higher energy consumption at night than during the day had shorter gestation and greater likelihood of delivering preterm. Misalignment of eating time with day-night cycles may be a contributing factor to preterm birth. This points to a potential target for intervention to reduce the risk of preterm birth. Observations for nightly sleep deprivation in relation to gestation length and PTB warrant further confirmation.
由于进餐时间不当或睡眠不足导致的母体代谢紊乱可能会扰乱昼夜节律，从而增加妊娠并发症的风险。本研究旨在探讨孕期夜间进食和睡眠时间与妊娠持续时间和早产的关系。
我们对来自新加坡成长至健康结局（GUSTO）队列的 673 名孕妇进行了研究。在妊娠 26-28 周时，通过 24 小时膳食回忆评估了孕妇每日不同时段的能量摄入和夜间睡眠时间。根据 24 小时膳食回忆，夜间进食定义为 19:00 至 06:59 期间摄入的总能量超过 50%。夜间睡眠时间短定义为夜间睡眠时间<6 小时。同时分析夜间进食和睡眠不足与 a）妊娠持续时间的关系，采用多元线性回归分析；b）早产（<37 周）的关系，采用逻辑回归分析。
总体而言，15.6%的孕妇存在夜间进食行为，12.3%的孕妇存在睡眠不足，6.8%的孕妇早产。调整混杂因素后，夜间进食与妊娠持续时间缩短 0.45 周（95%CI-0.75，-0.16）和早产风险升高 2.19 倍（1.01，4.72）相关。睡眠不足与妊娠持续时间缩短 0.33 周（-0.66，-0.01）相关，但与早产的关系无统计学意义（1.81；0.76，4.30）。
在妊娠期间，与白天相比，夜间能量摄入较高的孕妇妊娠持续时间更短，早产的风险更高。进食时间与昼夜节律不匹配可能是早产的一个促成因素。这提示我们，干预调整进食时间可能是降低早产风险的一个潜在目标。关于夜间睡眠不足与妊娠持续时间和早产之间关系的观察结果需要进一步证实。
