Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
Department of Statistics, University of Pittsburgh, Pittsburgh, PA, USA.
Int J Behav Med. 2021 Apr;28(2):200-206. doi: 10.1007/s12529-020-09887-4.
Women with prepregnancy overweight/obesity are at high risk for obstetric complications and cardiometabolic disease. Poorer sleep quality is associated with obesity in non-pregnant individuals and, during pregnancy, poor sleep predicts negative obstetric and health outcomes. This study examined sleep patterns among women with overweight/obesity and factors associated with different sleep trajectories during pregnancy.
Women (N = 146, 17-40 years old) with a prepregnancy body mass index ≥ 25 kg/m were recruited during early pregnancy. Participants reported demographic information and completed the Pittsburgh Sleep Quality Index (PSQI) at up to six monthly assessments, with the first assessment occurring between 12 and 20 weeks gestation and the final assessment between 35 weeks gestation and delivery. PSQI scores > 5 indicate "poor sleep."
On average, women's PSQI scores were 6.66 ± 3.58 in the first half of pregnancy and were significantly higher (worse) at the end of pregnancy (t(644) = 4.55, p < 0.001), with the greatest change occurring in the third trimester (t(636.3) = 3.72, p < 0.001). Women who currently smoked had poorer sleep than women who did not currently smoke (t(1) = 2.29, p = 0.02). Prepregnancy weight status, age, parity, race, education, and income were not significantly associated with sleep changes (t(1) < 1.76, ps > 0.08). The percentage of women with PSQI scores > 5 (the threshold for poor sleep quality) was 37-63% across assessments, with the greatest increase occurring during the third trimester (t(633) = 2.92, p = 0.004).
Sleep quality worsens during the third trimester and is associated with current smoking. Future studies of sleep during pregnancy should examine health outcomes among women with overweight/obesity and early intervention to mitigate sleep disturbances as pregnancy progresses.
孕前超重/肥胖的女性发生产科并发症和心血管代谢疾病的风险较高。非孕妇的睡眠质量较差与肥胖有关，而在怀孕期间，睡眠质量差会预测不良的产科和健康结局。本研究检查了超重/肥胖女性的睡眠模式以及与妊娠期间不同睡眠轨迹相关的因素。
在孕早期招募了 146 名（年龄 17-40 岁）孕前 BMI≥25kg/m2 的女性。参与者报告了人口统计学信息，并在最多六次的每月评估中完成了匹兹堡睡眠质量指数（PSQI），第一次评估在妊娠 12-20 周进行，最后一次评估在妊娠 35 周至分娩时进行。PSQI 评分>5 表示“睡眠质量差”。
平均而言，女性在妊娠前半段的 PSQI 评分为 6.66±3.58，在妊娠末期显著升高（更差）（t(644)=4.55，p<0.001），最大变化发生在孕晚期（t(636.3)=3.72，p<0.001）。目前吸烟的女性睡眠质量比不吸烟的女性差（t(1)=2.29，p=0.02）。孕前体重状况、年龄、产次、种族、教育程度和收入与睡眠变化无显著相关性（t(1)<1.76，p>0.08）。PSQI 评分>5（睡眠质量差的阈值）的女性百分比在评估中为 37-63%，最大的增加发生在孕晚期（t(633)=2.92，p=0.004）。
睡眠质量在孕晚期恶化，与目前吸烟有关。未来对妊娠期间睡眠的研究应检查超重/肥胖女性的健康结局，并在妊娠进展过程中进行早期干预以减轻睡眠障碍。
