Department of Pediatrics, Division of Neonatology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Sleep Res. 2023 Aug;32(4):e13822. doi: 10.1111/jsr.13822. Epub 2023 Jan 27.
The study objective was to explore associations of fetal and infant weight patterns and preterm birth with sleep and 24-h activity rhythm parameters at school-age. In our prospective population-based study, 1327 children were followed from birth to age 10-15 years. Fetal weight was estimated using ultrasound in the second and third trimester of pregnancy. Birth weight and gestational age were available from midwife registries. Infant weight was measured at 6, 12 and 24 months. Fetal and infant weight acceleration or deceleration were defined as a change of >0.67 standard deviation between the corresponding age intervals. At school-age, sleep duration, sleep efficiency, wake after sleep onset, social jetlag, inter-daily stability, and intra-daily variability were assessed using tri-axial wrist actigraphy for 9 consecutive nights. We observed that low birth weight (<2500 g) was associated with 0.24 standard deviation (95% confidence interval [CI] 0.04; 0.43) longer sleep duration compared to normal weight. Compared to normal growth, growth deceleration in fetal life and infancy was associated with 0.40 standard deviation (95% CI 0.07; 0.73) longer sleep duration, 0.44 standard deviation (95% CI 0.14; 0.73) higher sleep efficiency, and -0.41 standard deviation (95% CI -0.76; -0.07) shorter wake after sleep onset. A pattern of normal fetal growth followed by infant growth acceleration was associated with -0.40 standard deviation (95% CI -0.61; -0.19) lower inter-daily stability. Preterm birth was not associated with any sleep or 24-h rhythm parameters. Our findings showed that children with fetal and infant growth restriction had longer and more efficient sleep at school-age, which may be indicative of an increased need for sleep for maturational processes and development after a difficult start in life.
研究目的是探讨胎儿和婴儿体重模式以及早产与学龄儿童睡眠和 24 小时活动节律参数的关系。在我们这项前瞻性的基于人群的研究中，对 1327 名儿童从出生到 10-15 岁进行了随访。在妊娠的第二和第三个三个月期间使用超声估计胎儿体重。出生体重和胎龄可从助产士登记处获得。婴儿体重在 6、12 和 24 个月时进行测量。胎儿和婴儿体重加速或减速定义为在相应的年龄间隔内变化大于 0.67 个标准差。在学龄期，通过三轴腕部活动记录仪连续 9 晚评估睡眠持续时间、睡眠效率、睡眠起始后醒来、社会时差、日间内稳定性和日内变异性。我们发现，与正常体重相比，低出生体重（<2500 克）与 0.24 个标准差（95%置信区间 [CI]：0.04；0.43）的睡眠时间更长相关。与正常生长相比，胎儿期和婴儿期的生长减速与 0.40 个标准差（95%CI：0.07；0.73）的睡眠时间更长、0.44 个标准差（95%CI：0.14；0.73）的睡眠效率更高和 0.41 个标准差（95%CI：0.76；-0.07）的睡眠起始后醒来时间更短相关。正常胎儿生长后婴儿生长加速的模式与 -0.40 个标准差（95%CI：-0.61；-0.19）的日间内稳定性更低相关。早产与任何睡眠或 24 小时节律参数均无关。我们的研究结果表明，胎儿和婴儿生长受限的儿童在学龄期有更长和更有效的睡眠，这可能表明在生命艰难的开端后，为了成熟过程和发育，他们对睡眠的需求增加。
