Social and Scientific Systems, Durham, NC, USA.
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Sleep Res. 2020 Oct;29(5):e13000. doi: 10.1111/jsr.13000. Epub 2020 Feb 29.
Sleep disturbances among pregnant women are increasingly linked to suboptimal maternal/birth outcomes. Few studies in the USA investigating sleep by pregnancy status have included racially/ethnically diverse populations, despite worsening disparities in adverse birth outcomes. Using a nationally representative sample of 71,644 (2,349 pregnant) women from the National Health Interview Survey (2004-2017), we investigated relationships between self-reported pregnancy and six sleep characteristics stratified by race/ethnicity. We also examined associations between race/ethnicity and sleep stratified by pregnancy status. We used average marginal predictions from fitted logistic regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each sleep dimension, adjusting for sociodemographic and health characteristics. Pregnant women were less likely than non-pregnant women to report short sleep (PR = 0.75; 95% CI, 0.68-0.82) and more likely to report long sleep (PR = 2.06; 95% CI, 1.74-2.43) and trouble staying asleep (PR = 1.34; 95% CI, 1.25-1.44). The association between pregnancy and sleep duration was less pronounced among women aged 35-49 years compared to those <35 years. Among white women, sleep medication use was less prevalent among pregnant compared to non-pregnant women (PR = 0.45; 95% CI, 0.31-0.64), but this association was not observed among black women (PR = 0.98; 95% CI, 0.46-2.09) and was less pronounced among Hispanic/Latina women (PR = 0.82; 95% CI, 0.38-1.77). Compared to pregnant white women, pregnant black women had a higher short sleep prevalence (PR = 1.35; 95% CI, 1.08-1.67). Given disparities in maternal/birth outcomes and sleep, expectant mothers (particularly racial/ethnic minorities) may need screening followed by treatment for sleep disturbances. Our findings should be interpreted in the historical and sociocultural context of the USA.
孕妇睡眠障碍与产妇/分娩不良结局之间的联系日益密切。在美国，很少有研究根据妊娠状况调查睡眠，尽管不良分娩结局的差异在不断恶化。本研究利用全国代表性样本（71644 名妇女，其中 2349 名孕妇），采用来自全国健康访谈调查（2004-2017 年）的数据，调查了自我报告妊娠与 6 种睡眠特征之间的关系，根据种族/民族进行分层。我们还研究了妊娠状况和种族/民族之间的睡眠关系。我们使用拟合逻辑回归模型的平均边缘预测来估计每个睡眠维度的患病率比（PR）和 95%置信区间（CI），并调整了社会人口统计学和健康特征。与非孕妇相比，孕妇更有可能报告短睡眠（PR = 0.75；95%CI，0.68-0.82），而不太可能报告长睡眠（PR = 2.06；95%CI，1.74-2.43）和难以入睡（PR = 1.34；95%CI，1.25-1.44）。与<35 岁的女性相比，35-49 岁的女性妊娠与睡眠持续时间的相关性较弱。在白人女性中，与非孕妇相比，孕妇使用睡眠药物的比例较低（PR = 0.45；95%CI，0.31-0.64），但这一关联在黑人女性中并不明显（PR = 0.98；95%CI，0.46-2.09），在西班牙裔/拉丁裔女性中也不明显（PR = 0.82；95%CI，0.38-1.77）。与白人孕妇相比，黑人孕妇短睡眠的发生率更高（PR = 1.35；95%CI，1.08-1.67）。鉴于产妇/分娩结局和睡眠存在差异，孕妇（特别是少数族裔）可能需要进行睡眠障碍筛查，随后进行治疗。我们的研究结果应结合美国的历史和社会文化背景进行解释。
