Department of Medical Education, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States of America.
Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America.
PLoS One. 2022 Aug 4;17(8):e0272218. doi: 10.1371/journal.pone.0272218. eCollection 2022.
Shift work has been associated with adverse pregnancy outcomes. The objective of this study was to evaluate the association between sleep disturbances and adverse pregnancy outcomes.
This was a secondary analysis of a prospective study of participants enrolled in a prospective observational study wherein gravidae were screened for sleep apnea (2010-2012). A screening questionnaire with standard sleep apnea questionnaires as well as novel items about shift work and nocturnal sleep duration was administered at a prenatal care visit. Short sleep duration was defined as less than 7 hours. Prolonged sleep duration was defined as greater than 9 hours. In a cohort of 1125 pregnant people, 9.4% reported shift work at the time of screening. Gravidae who reported shift work were more likely than gravidae who reported no shift work to develop preeclampsia (28.3% versus 13.0%, P<0.001), preeclamspsia with severe features (16.0% versus 8.5%, P = 0.010), gestational diabetes (28.3% versus 19.9%, P = 0.041), and a composite of adverse obstetric outcomes (61.3% versus 47.8%, P = 0.008). After adjusting for potentially confounding variables, shift work was associated with an increased risk for preeclampsia with (adjusted relative risk (aRR) 1.70, 95% CI 1.03-2.79, p = 0.036) and without (aRR 2.03, 95% CI 1.43-2.90, p<0.001) severe features, and gestational diabetes mellitus class A1 (aRR 1.47, 95% CI 1.05-2.05, p = 0.023) and class A2 (aRR 1.67, 95% CI 1.13-2.44, p = 0.009). Sleep duration was associated with gestational diabetes (31.3% among those with short sleep duration, 25.2% among those with normal sleep duration and 14.0% among those with prolonged sleep duration, P<0.001) and gestational diabetes class A2 (29.5%, 17.9%, and 10.1%, respectively, P<0.001). Gravidae with prolonged sleep duration experienced less composite adverse pregnancy outcomes at 42.6% compared to 57.4% for those with short sleep duration or 52.5% for those with normal sleep duration, P = 0.002.
Shift work and sleep duration are both associated with adverse pregnancy outcomes. Further research on the impact of sleep disturbance on pregnancy outcomes is warranted.
轮班工作与不良妊娠结局有关。本研究的目的是评估睡眠障碍与不良妊娠结局之间的关系。
这是对参加前瞻性观察研究的参与者进行的一项前瞻性研究的二次分析，其中在产前保健就诊时对睡眠呼吸暂停进行了筛查（2010-2012 年）。在一项关于轮班工作和夜间睡眠时间的标准睡眠呼吸暂停问卷以及新问题的调查问卷中，睡眠时间短定义为少于 7 小时，睡眠时间长定义为大于 9 小时。在 1125 名孕妇队列中，9.4%的人在筛查时报告有轮班工作。与没有轮班工作的孕妇相比，报告轮班工作的孕妇更有可能发生子痫前期（28.3%与 13.0%，P<0.001）、有严重特征的子痫前期（16.0%与 8.5%，P=0.010）、妊娠期糖尿病（28.3%与 19.9%，P=0.041）和不良产科结局的综合（61.3%与 47.8%，P=0.008）。在调整了潜在的混杂变量后，轮班工作与子痫前期（调整后的相对风险（aRR）1.70，95%CI 1.03-2.79，p=0.036）和无严重特征的子痫前期（aRR 2.03，95%CI 1.43-2.90，p<0.001）以及妊娠期糖尿病 A1 类（aRR 1.47，95%CI 1.05-2.05，p=0.023）和 A2 类（aRR 1.67，95%CI 1.13-2.44，p=0.009）的风险增加相关。睡眠时长与妊娠期糖尿病（睡眠时间短者占 31.3%，睡眠时间正常者占 25.2%，睡眠时间长者占 14.0%，P<0.001）和妊娠期糖尿病 A2 类（分别为 29.5%、17.9%和 10.1%，P<0.001）相关。与睡眠时间短或睡眠时间正常的孕妇相比，睡眠时间长的孕妇不良妊娠结局综合发生率较低，为 42.6%，而睡眠时间短的孕妇为 57.4%，睡眠时间正常的孕妇为 52.5%，P=0.002。
轮班工作和睡眠时长均与不良妊娠结局有关。需要进一步研究睡眠障碍对妊娠结局的影响。
