Maternal sleep practices and stillbirth: Findings from an international case-control study

the STARS Consortium

    Research output: Contribution to journalArticle

    Abstract

    Background: Late stillbirth, which occurs ≥28 weeks’ gestation, affects 1.3-8.8 per 1000 births in high-income countries. Of concern, most occur in women without established risk factors. Identification of potentially modifiable risk factors that relate to maternal behaviors remains a priority in stillbirth prevention research. This study aimed to investigate, in an international cohort, whether maternal sleep practices are related to late stillbirth. Methods: An Internet-based case-control study of women who had a stillbirth ≥28 weeks’ gestation within 30 days before completing the survey (n = 153) and women with an ongoing third-trimester pregnancy or who had delivered a live born child within 30 days (n = 480). Bivariate and multivariate logistic regressions were used to determine unadjusted and adjusted odds ratios (OR and aOR, respectively) with 95% confidence intervals (95% CIs) for stillbirth. Results: Sleeping >9 hours per night in the previous month was associated with stillbirth (aOR 1.75 [95% CI 1.10-2.79]), as was waking on the right side (2.27 [1.31-3.92]). Nonrestless sleep in the last month was also found to be associated with stillbirth (1.73 [1.03-2.99]), with good sleep quality in the last month approaching significance (1.64 [0.98-2.75]). On the last night of pregnancy, not waking more than one time was associated with stillbirth (2.03 [1.24-3.34]). No relationship was found with going to sleep position during pregnancy, although very few women reported settling in the supine position (2.4%). Conclusions: Long periods of undisturbed sleep are associated with late stillbirth. Physiological studies of how the neuroendocrine and autonomic system pathways are regulated during sleep in the context of late pregnancy are warranted.

    Original languageEnglish (US)
    JournalBirth
    DOIs
    StateAccepted/In press - Jan 1 2019

    Fingerprint

    Stillbirth
    Case-Control Studies
    Sleep
    Mothers
    Pregnancy
    Confidence Intervals
    Autonomic Pathways
    Maternal Behavior
    Neurosecretory Systems
    Supine Position
    Third Pregnancy Trimester
    Internet
    Logistic Models
    Odds Ratio
    Parturition

    Keywords

    • maternal sleep
    • sleep duration
    • stillbirth

    ASJC Scopus subject areas

    • Obstetrics and Gynecology

    Cite this

    Maternal sleep practices and stillbirth : Findings from an international case-control study. / the STARS Consortium.

    In: Birth, 01.01.2019.

    Research output: Contribution to journalArticle

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    title = "Maternal sleep practices and stillbirth: Findings from an international case-control study",
    abstract = "Background: Late stillbirth, which occurs ≥28 weeks’ gestation, affects 1.3-8.8 per 1000 births in high-income countries. Of concern, most occur in women without established risk factors. Identification of potentially modifiable risk factors that relate to maternal behaviors remains a priority in stillbirth prevention research. This study aimed to investigate, in an international cohort, whether maternal sleep practices are related to late stillbirth. Methods: An Internet-based case-control study of women who had a stillbirth ≥28 weeks’ gestation within 30 days before completing the survey (n = 153) and women with an ongoing third-trimester pregnancy or who had delivered a live born child within 30 days (n = 480). Bivariate and multivariate logistic regressions were used to determine unadjusted and adjusted odds ratios (OR and aOR, respectively) with 95{\%} confidence intervals (95{\%} CIs) for stillbirth. Results: Sleeping >9 hours per night in the previous month was associated with stillbirth (aOR 1.75 [95{\%} CI 1.10-2.79]), as was waking on the right side (2.27 [1.31-3.92]). Nonrestless sleep in the last month was also found to be associated with stillbirth (1.73 [1.03-2.99]), with good sleep quality in the last month approaching significance (1.64 [0.98-2.75]). On the last night of pregnancy, not waking more than one time was associated with stillbirth (2.03 [1.24-3.34]). No relationship was found with going to sleep position during pregnancy, although very few women reported settling in the supine position (2.4{\%}). Conclusions: Long periods of undisturbed sleep are associated with late stillbirth. Physiological studies of how the neuroendocrine and autonomic system pathways are regulated during sleep in the context of late pregnancy are warranted.",
    keywords = "maternal sleep, sleep duration, stillbirth",
    author = "{the STARS Consortium} and O’Brien, {Louise M.} and Jane Warland and Tomasina Stacey and Heazell, {Alexander E.P.} and Mitchell, {Edwin A.} and Collins, {J. H.} and Jennifer Huberty and Kliman, {H. J.} and McGregor, {J. A.} and M. Parast and M. Peesay and Wimmer, {L. J.}",
    year = "2019",
    month = "1",
    day = "1",
    doi = "10.1111/birt.12416",
    language = "English (US)",
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    T1 - Maternal sleep practices and stillbirth

    T2 - Findings from an international case-control study

    AU - the STARS Consortium

    AU - O’Brien, Louise M.

    AU - Warland, Jane

    AU - Stacey, Tomasina

    AU - Heazell, Alexander E.P.

    AU - Mitchell, Edwin A.

    AU - Collins, J. H.

    AU - Huberty, Jennifer

    AU - Kliman, H. J.

    AU - McGregor, J. A.

    AU - Parast, M.

    AU - Peesay, M.

    AU - Wimmer, L. J.

    PY - 2019/1/1

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    N2 - Background: Late stillbirth, which occurs ≥28 weeks’ gestation, affects 1.3-8.8 per 1000 births in high-income countries. Of concern, most occur in women without established risk factors. Identification of potentially modifiable risk factors that relate to maternal behaviors remains a priority in stillbirth prevention research. This study aimed to investigate, in an international cohort, whether maternal sleep practices are related to late stillbirth. Methods: An Internet-based case-control study of women who had a stillbirth ≥28 weeks’ gestation within 30 days before completing the survey (n = 153) and women with an ongoing third-trimester pregnancy or who had delivered a live born child within 30 days (n = 480). Bivariate and multivariate logistic regressions were used to determine unadjusted and adjusted odds ratios (OR and aOR, respectively) with 95% confidence intervals (95% CIs) for stillbirth. Results: Sleeping >9 hours per night in the previous month was associated with stillbirth (aOR 1.75 [95% CI 1.10-2.79]), as was waking on the right side (2.27 [1.31-3.92]). Nonrestless sleep in the last month was also found to be associated with stillbirth (1.73 [1.03-2.99]), with good sleep quality in the last month approaching significance (1.64 [0.98-2.75]). On the last night of pregnancy, not waking more than one time was associated with stillbirth (2.03 [1.24-3.34]). No relationship was found with going to sleep position during pregnancy, although very few women reported settling in the supine position (2.4%). Conclusions: Long periods of undisturbed sleep are associated with late stillbirth. Physiological studies of how the neuroendocrine and autonomic system pathways are regulated during sleep in the context of late pregnancy are warranted.

    AB - Background: Late stillbirth, which occurs ≥28 weeks’ gestation, affects 1.3-8.8 per 1000 births in high-income countries. Of concern, most occur in women without established risk factors. Identification of potentially modifiable risk factors that relate to maternal behaviors remains a priority in stillbirth prevention research. This study aimed to investigate, in an international cohort, whether maternal sleep practices are related to late stillbirth. Methods: An Internet-based case-control study of women who had a stillbirth ≥28 weeks’ gestation within 30 days before completing the survey (n = 153) and women with an ongoing third-trimester pregnancy or who had delivered a live born child within 30 days (n = 480). Bivariate and multivariate logistic regressions were used to determine unadjusted and adjusted odds ratios (OR and aOR, respectively) with 95% confidence intervals (95% CIs) for stillbirth. Results: Sleeping >9 hours per night in the previous month was associated with stillbirth (aOR 1.75 [95% CI 1.10-2.79]), as was waking on the right side (2.27 [1.31-3.92]). Nonrestless sleep in the last month was also found to be associated with stillbirth (1.73 [1.03-2.99]), with good sleep quality in the last month approaching significance (1.64 [0.98-2.75]). On the last night of pregnancy, not waking more than one time was associated with stillbirth (2.03 [1.24-3.34]). No relationship was found with going to sleep position during pregnancy, although very few women reported settling in the supine position (2.4%). Conclusions: Long periods of undisturbed sleep are associated with late stillbirth. Physiological studies of how the neuroendocrine and autonomic system pathways are regulated during sleep in the context of late pregnancy are warranted.

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