Zhu Mia Q, Cnattingius Sven, O'Brien Louise M, Villamor Eduardo
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Sleep. 2025 Jan 13;48(1). doi: 10.1093/sleep/zsae236.
To investigate the association between maternal early pregnancy body mass index (BMI) and risk of offspring insomnia.
We conducted a nationwide cohort study among 3 281 803 singleton live births in Sweden born 1983-2015. Using national registries with prospectively recorded information, we followed participants for an insomnia diagnosis from 2 to up to 35 years of age. We compared insomnia risks by early pregnancy BMI categories using hazard ratios (HR) with 95% confidence intervals (CI) from adjusted Cox models. To assess unmeasured shared familial confounding, we conducted sibling-controlled analyses among 1 724 473 full siblings and studied the relation of maternal full sisters' BMI and insomnia risk in 1 185 998 offspring.
There were 7154 insomnia diagnoses over a median follow-up age of 17.9 years. Compared with women with normal BMI, adjusted HR (95% CI) of offspring insomnia for early pregnancy BMI categories overweight, obesity class I, and obesity classes II or III were, respectively, 1.22 (1.14, 1.30), 1.60 (1.45, 1.77), and 2.11 (1.83, 2.45). Corresponding adjusted HR (95% CI) in sibling comparisons were, respectively, 1.32 (1.05, 1.65), 1.48 (1.03, 2.14), and 1.56 (0.91, 2.65). Associations with maternal sisters' BMI were attenuated, suggesting a weak role for unmeasured shared factors. Other pregnancy, birth, and neonatal complications were associated with the risk of insomnia in offspring but did not substantially mediate the association.
The dose-response relation between maternal overweight and obesity severity with offspring insomnia risk is not fully explained by shared familial factors.
探讨孕早期孕妇体重指数（BMI）与子代失眠风险之间的关联。
我们在瑞典对1983年至2015年出生的3281803例单胎活产进行了一项全国性队列研究。利用前瞻性记录信息的国家登记处，我们对参与者进行随访，直至其2至35岁时被诊断为失眠。我们使用校正Cox模型的风险比（HR）及95%置信区间（CI），比较不同孕早期BMI类别下的失眠风险。为评估未测量的共同家族混杂因素，我们在1724473例全同胞中进行了同胞对照分析，并研究了1185998例子代中母亲的亲姐妹BMI与失眠风险的关系。
在中位随访年龄17.9岁期间，共有7154例失眠诊断。与BMI正常的女性相比，孕早期BMI类别为超重、I级肥胖、II级或III级肥胖的子代失眠校正HR（95%CI）分别为1.22（1.14，1.30）、1.60（1.45，1.77）和2.11（1.83，2.45）。同胞对照比较中的相应校正HR（95%CI）分别为1.32（1.05，1.65）、1.48（1.03，2.14）和1.56（0.91，2.65）。与母亲姐妹BMI的关联有所减弱，表明未测量的共同因素作用较弱。其他妊娠、分娩和新生儿并发症与子代失眠风险相关，但并未实质性介导这种关联。
母亲超重和肥胖严重程度与子代失眠风险之间的剂量反应关系不能完全由共同家族因素解释。
