Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.
Diabetes Metab. 2021 Sep;47(5):101217. doi: 10.1016/j.diabet.2020.101217. Epub 2020 Dec 16.
As cohort studies of the impact of sleep duration during early pregnancy on gestational diabetes mellitus (GDM) are lacking, our study aimed to explore the association between sleep duration in the first trimester and GDM in one region of mainland China.
For this prospective cohort study, sleep duration data were collected from 3692 pregnant women at the first prenatal care appointment before 14 weeks of gestation. Multivariable log-binomial regression models were used to analyze the association of sleep duration with GDM after adjusting for demographic characteristics, health status (such as family history of diabetes, history of GDM, prepregnancy body mass index, gestational weight gain) and lifestyle habits (such as physical activity, dietary intakes).
Our cohort included 166 (4.5%) short sleepers and 505 (14%) long sleepers. Shorter sleep duration was more likely to be observed in women aged ≥35 years who were multiparous, and had previous pregnancy, insufficient gestational weight gain, engaged in more vigorous physical activity, drank alcohol, were vegan and/or never took folic-acid supplements. Compared with normal sleepers (29%), the prevalence of GDM was significantly higher in short sleepers (38%; P = 0.01), but not in long sleepers (31%; P = 0.224). In the multivariable model, women with short sleep durations during early pregnancy had a 32% greater risk of GDM [adjusted risk ratio (aRR): 1.32, 95% CI: 1.06-1.63], whereas long sleepers did not (aRR: 1.09, 95% CI: 0.94-1.26).
Short sleep duration during early pregnancy is associated with an increased risk of GDM. This suggests that more attention should be paid to controlling the development of GDM in pregnant women with insufficient sleep.
由于缺乏关于孕早期睡眠时间对妊娠期糖尿病（GDM）影响的队列研究，本研究旨在探索中国某一地区孕早期睡眠时间与 GDM 之间的关系。
本前瞻性队列研究在孕 14 周前的首次产前检查时，收集了 3692 名孕妇的睡眠时长数据。采用多变量二项式回归模型，在校正人口统计学特征、健康状况（如糖尿病家族史、GDM 病史、孕前体重指数、妊娠期体重增加）和生活方式习惯（如体力活动、饮食摄入）后，分析睡眠时长与 GDM 的关联。
本队列包括 166 名（4.5%）短睡眠者和 505 名（14%）长睡眠者。年龄≥35 岁、多胎、有既往妊娠、妊娠期体重增加不足、从事更多剧烈体力活动、饮酒、素食且/或从未服用叶酸补充剂的女性，更有可能出现较短的睡眠时间。与正常睡眠者（29%）相比，短睡眠者（38%；P=0.01）GDM 的患病率显著更高，但长睡眠者（31%；P=0.224）并非如此。在多变量模型中，孕早期睡眠时间较短的女性患 GDM 的风险增加 32%[调整后的风险比（aRR）：1.32，95%可信区间（CI）：1.06-1.63]，而长睡眠者则没有（aRR：1.09，95% CI：0.94-1.26）。
孕早期睡眠不足与 GDM 风险增加相关。这表明，对于睡眠不足的孕妇，应更加关注 GDM 的发展并加以控制。
