Kominiarek Michelle A, Yeh Chen, Balmert Lauren C, Facco Francesca, Grobman William, Simon Melissa
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
AJP Rep. 2020 Jul;10(3):e309-e314. doi: 10.1055/s-0040-1715172. Epub 2020 Sep 23.
The aim of this study was to describe sleep duration across gestation in women who wore an activity-tracking device (ATD) during pregnancy, and to study the association between sleep duration and adverse maternal and neonatal outcomes Women ≥ 18 years old who owned a smartphone were approached to participate in 2016 to 2017. Participants received instructions to wear and sync an ATD daily. Steps, sedentary hours, and sleep duration were wirelessly transmitted via cellular technology. We measured sleep duration for the main episode of sleep and excluded sleep times < 120 minutes. Mixed models were used to assess the trajectory of mean weekly hours of sleep by gestational age. Secondary analyses evaluated differences in pregnancy outcomes between insufficient (< 7/24 hours) and sufficient sleep (≥ 7/24 hours) groups, based on mean hours of sleep within the first 7 days of ATD use. The majority of 94 participants self-reported minority racial-ethnic status (33% non-Hispanic black and 51% Hispanic), had government insurance (83%), were nulliparous (61%), and had pre-pregnancy overweight or obesity (56%). The mean (standard deviation) duration of sleep was 7.2 ± 2.4 hours per 24 hours. In mixed models analyses, gestational age was statistically significantly associated with mean hours of sleep ( = -0.02; 95% confidence interval: -0.04 to -0.01; < 0.001). Women who had < 7 hours of sleep had greater median daily steps compared with those who had ≥ 7 hours of sleep (median: 7,122; interquartile range [IQR]: 5,167-8,338 vs. median: 5,005; IQR: 4,115-7,059; < 0.01), but there were no significant differences in other outcomes (sedentary time, gestational weight gain, pregnancy associated hypertension, gestational diabetes, gestational age at delivery, cesarean delivery, or mean birthweight), > 0.05 for all comparisons. The mean sleep duration was 7.2 ± 2.4 hours among the 94 women in this cohort and decreased with advancing gestational age. Further research is required to evaluate sleep measurements with ATD in pregnant women and how sleep duration and quality is related to maternal and neonatal outcomes.
本研究旨在描述孕期佩戴活动追踪设备(ATD)的女性整个孕期的睡眠时间,并研究睡眠时间与不良母婴结局之间的关联。2016年至2017年,研究人员邀请年龄≥18岁且拥有智能手机的女性参与研究。参与者收到了每天佩戴并同步ATD的指导。步数、久坐时长和睡眠时间通过蜂窝技术进行无线传输。我们测量了主要睡眠时段的睡眠时间,并排除了<120分钟的睡眠时间。使用混合模型评估按孕周计算的平均每周睡眠时间轨迹。二次分析根据ATD使用前7天的平均睡眠时间,评估睡眠不足(<7/24小时)组和充足睡眠(≥7/24小时)组之间妊娠结局的差异。
94名参与者中的大多数自我报告为少数族裔种族身份(33%为非西班牙裔黑人,51%为西班牙裔),拥有政府保险(83%),初产妇(61%),孕前超重或肥胖(56%)。每24小时的平均(标准差)睡眠时间为7.2±2.4小时。在混合模型分析中,孕周与平均睡眠时间在统计学上显著相关(β=-0.02;95%置信区间:-0.04至-0.01;P<0.001)。睡眠时间<7小时的女性与睡眠时间≥7小时的女性相比,每日步数中位数更高(中位数:7,122;四分位间距[IQR]:5,167-8,338 vs.中位数:5,005;IQR:4,115-7,059;P<0.01),但在其他结局(久坐时间、孕期体重增加、妊娠相关高血压、妊娠期糖尿病、分娩孕周、剖宫产或平均出生体重)方面无显著差异,所有比较的P>0.05。
该队列中94名女性的平均睡眠时间为7.2±2.4小时,且随着孕周增加而减少。需要进一步研究以评估ATD在孕妇中进行睡眠测量的情况,以及睡眠时间和质量与母婴结局之间的关系。