Li Yong-Sin, Lee Hsin-Chien, Huang Jian-Pei, Lin Ya-Zhu, Au Heng-Kien, Lo Yu-Chun, Chien Ling-Chu, Chao Hsing-Jasmine, Estinfort Wanda, Chen Yi-Hua
School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan.
Sleep Med. 2023 May;105:68-77. doi: 10.1016/j.sleep.2023.02.022. Epub 2023 Mar 2.
Although studies have reported the effects of inadequate sleep on maternal health, few have examined the relationships of maternal sleep patterns with fetal health and early childhood development. This study investigated maternal sleep duration patterns from early pregnancy to 3-years postpartum and their effects on birth outcomes and child development.
This study recruited pregnant women and their partners during prenatal visits at five selected hospitals in the Taipei area; follow-up lasted from July 2011 to April 2021. A total of 1178 parents completed self-reported assessments from early pregnancy until childbirth and 544 completed eight assessments up to 3-years postpartum. Generalized estimated equation models were used for analyses.
Group-based trajectory modeling was used to identify four trajectories of sleep duration patterns. Although maternal sleep duration was not associated with birth outcomes, maternal "short decreasing" and "stably short" sleep patterns were associated with a higher risk of suspected overall developmental delay and language developmental delay, respectively. Furthermore, an "extremely long decreasing" pattern was associated with a higher risk of suspected overall developmental delay, [adjusted odds ratio (aOR) = 2.97, 95% confidence interval (CI):1.39-6.36)], gross motor delay, (aOR = 3.14, 95% CI: 1.42-6.99) and language developmental delay (aOR = 4.59, 95% CI:1.62-13.00). The results were significant for the children of multiparous women.
We identified a U-shaped distribution of risk between offspring developmental delay and maternal prenatal sleep duration, with the highest risk levels on both ends of the maternal prenatal sleep duration pattern. Interventions for maternal sleep are relatively straightforward to implement and should thus be a key part of standard prenatal care.
尽管已有研究报道睡眠不足对孕产妇健康的影响，但很少有研究探讨孕产妇睡眠模式与胎儿健康及幼儿发育之间的关系。本研究调查了从孕早期到产后3年的孕产妇睡眠时长模式及其对分娩结局和儿童发育的影响。
本研究在台北地区五家选定医院的产前检查期间招募了孕妇及其伴侣；随访从2011年7月持续至2021年4月。共有1178名父母完成了从孕早期到分娩的自我报告评估，544名完成了产后3年的八项评估。采用广义估计方程模型进行分析。
基于群体的轨迹模型用于识别睡眠时长模式的四种轨迹。尽管孕产妇睡眠时长与分娩结局无关，但孕产妇“短且递减”和“持续短”的睡眠模式分别与疑似总体发育迟缓及语言发育迟缓的较高风险相关。此外，“极长且递减”模式与疑似总体发育迟缓的较高风险相关[调整优势比（aOR）=2.97，95%置信区间（CI）：1.39 - 6.36]、大运动发育迟缓（aOR = 3.14，95% CI：1.42 - 6.99）以及语言发育迟缓（aOR = 4.59，95% CI：1.62 - 13.00）。经产妇的子女结果具有显著性。
我们发现后代发育迟缓与孕产妇产前睡眠时长之间存在U型风险分布，在孕产妇产前睡眠时长模式的两端风险水平最高。针对孕产妇睡眠的干预措施相对易于实施，因此应成为标准产前护理的关键部分。
