Modification of Maternal Sleep Position to Optimise Fetal Well-being in Late Pregnancy: A Survey in a Multicultural New Zealand Region

The supine sleep position in late pregnancy is a major risk factor for stillbirth, with a population attributable risk of 5.8% and one in four pregnant women reportedly sleeping in a supine position. Although the mechanisms linking the supine sleep position and late stillbirth remain unclear, there is evidence that it exacerbates pre-existing maternal sleep disordered breathing, which is another known risk factor for adverse perinatal outcomes. Given that maternal sleep position is a potentially modifiable risk factor, the aim of this study was to characterize and correlate uteroplacental and fetal hemodynamics, including cardiac function, in a cohort of women with apparently uncomplicated pregnancies with their nocturnal sleep position. This was a prospective observational cohort study at an Australian tertiary obstetric hospital. Women were asked to complete a series of questions related to their sleep position in late pregnancy after 35 weeks of completed gestation. They also underwent an ultrasound assessment where Doppler indices of various fetoplacental vessels and fetal cardiac function were measured. Regional cerebral perfusion was also assessed. Pregnancy outcome data was extracted from the electronic hospital database for analysis. A total of 274 women were included in the final analysis. Of these, 78.1% (214/274) reported no supine sleep, and 21.9% (60/274) reported going to sleep in a supine position. The middle cerebral artery, anterior cerebral artery, and vertebral artery pulsatility indices were all significantly lower in the supine sleep cohort, as was the cerebroplacental ratio. There were no significant differences in the mode or indication for delivery or in serious neonatal outcomes, including 5-min Apgar score < 7, acidosis, and neonatal intensive care unit admission between cohorts. Women in the supine cohort were more likely to have an infant with a BW > 90th centile (p = 0.04). This data demonstrates fetal brain sparing in association with the maternal supine sleep position in a low-risk population. This data contributes to the growing body of literature attempting to elucidate the etiological pathways responsible for the association of late stillbirth with the maternal supine sleep position.

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Modification of maternal late pregnancy sleep position: a survey evaluation of a New Zealand public health campaign

BMJ Open ◽

10.1136/bmjopen-2020-047681 ◽

2021 ◽

Vol 11 (5) ◽

pp. e047681

Author(s):

Robin S Cronin ◽

John M D Thompson ◽

Rennae S Taylor ◽

Jessica Wilson ◽

Karen F Falloon ◽

...

Keyword(s):

Public Health ◽

New Zealand ◽

Pregnant Women ◽

Supine Position ◽

Health Professionals ◽

Primary Outcome ◽

Late Pregnancy ◽

Sleep Position ◽

Public Health Campaign ◽

Health Campaign

IntroductionA ‘Sleep-On-Side When Baby’s Inside’ public health campaign was initiated in New Zealand in 2018. This was in response to evidence that maternal supine going-to-sleep position was an independent risk factor for stillbirth from 28 weeks’ gestation. We evaluated the success of the campaign on awareness and modification of late pregnancy going-to-sleep position through nationwide surveys.Methods and analysisTwo web-based cross-sectional surveys were conducted over 12 weeks in 2019–2020 in a sample of (1) pregnant women ≥28 weeks, primary outcome of going-to-sleep position; and (2) health professionals providing pregnancy care, primary outcome of knowledge of going-to-sleep position and late stillbirth risk. Univariable logistic regression was performed to identify factors associated with supine going-to-sleep position.DiscussionThe survey of pregnant women comprised 1633 eligible participants. Going-to-sleep position last night was supine (30, 1.8%), non-supine (1597, 97.2%) and no recall (16, 1.0%). Supine position had decreased from 3.9% in our previous New Zealand-wide study (2012–2015). Most women (1412, 86.5%) had received sleep-on-side advice with no major resultant worry (1276, 90.4%). Two-thirds (918, 65.0%) had changed their going-to-sleep position based on advice, with most (611 of 918, 66.5%) reporting little difficulty. Supine position was associated with Māori (OR 5.05, 95% CI 2.10 to 12.1) and Asian-non-Indian (OR 4.20, 95% CI 1.27 to 13.90) ethnicity; single (OR 10.98, 95% CI 4.25 to 28.42) and cohabitating relationship status (OR 2.69, 95% CI 1.09 to 6.61); hospital-based maternity provider (OR 2.55, 95% CI 1.07 to 6.10); education overseas (OR 3.92, 95% CI 1.09 to 14.09) and primary-secondary level (OR 2.80, 95% CI 1.32 to 6.08); and not receiving sleep-on-side advice (OR 6.70, 95% CI 3.23 to 13.92). The majority of health professionals (709 eligible participants) reported awareness of supine going-to-sleep position and late stillbirth risk (543, 76.6%).ConclusionMost pregnant women had received and implemented sleep-on-side advice without major difficulty or concern. Some groups of women may need a tailored approach to acquisition of going-to-sleep position information.

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Survey of maternal sleep practices in late pregnancy in a multi-ethnic sample in South Auckland, New Zealand

BMC Pregnancy and Childbirth ◽

10.1186/s12884-017-1378-5 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 8

Author(s):

Robin S. Cronin ◽

Carol Chelimo ◽

Edwin A. Mitchell ◽

Kara Okesene-Gafa ◽

John M. D. Thompson ◽

...

Keyword(s):

New Zealand ◽

Late Pregnancy ◽

Maternal Sleep

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Factors that Affect Ppsychological Well-being in a New Zealand Sample of Maltreated Children

PsycEXTRA Dataset ◽

10.1037/e516542013-080 ◽

2012 ◽

Author(s):

Sarah Wolstenholme ◽

Fred Seymour

Keyword(s):

New Zealand ◽

Well Being ◽

Maltreated Children

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Factors that affect psychological well-being in a New Zealand sample of maltreated children

PsycEXTRA Dataset ◽

10.1037/e556572013-118 ◽

2012 ◽

Author(s):

Sarah Wolstenholme

Keyword(s):

New Zealand ◽

Well Being ◽

Psychological Well Being ◽

Maltreated Children

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How Does Being Solo in Nature Affect Well-Being? Evidence from Norway, Germany and New Zealand

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157897 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7897

Author(s):

Evi Petersen ◽

Annette Bischoff ◽

Gunnar Liedtke ◽

Andrew J. Martin

Keyword(s):

New Zealand ◽

Outdoor Education ◽

Positive Emotions ◽

Qualitative Content Analysis ◽

Well Being ◽

National Sample ◽

Gender And Age ◽

Health Initiatives ◽

Perception Of Time ◽

Prior Experiences

Background: Solo—being intentionally solitary in nature—is receiving growing attention as a valuable outdoor education program component. Its practice and history have been researched in the context of experiential learning, but few studies have explicitly examined how solo experiences can affect dimensions of well-being. This study investigated a broad range of well-being pathways provided by being solo, based on data from Norway, Germany, and New Zealand. Methods: Using qualitative content analysis (QCA), the solo debrief responses of 40 participants (26 females, age: 19–64 years) were analysed, applying the PERMA-V framework (emotions, engagement, relationship, meaning, achievement, and vitality). Variations in the reports were explored as a function of the national sample, gender, age, prior solo experiences and expectations. Results: The study suggests that hedonic and eudemonic well-being pathways, represented by the six PERMA-V pillars, interrelate strongly. The experience of a range of positive emotions and connecting process during solo highlights two of the most frequent findings related to well-being pathways. The secondary findings suggest minor variations in the well-being pathways for the different national samples, gender and age. Expectations and prior experiences with solo were identified as context factors with minor impact. Further, the data-driven analysis identified specific physical activities, landscape features, sense-activation, perception of time and ‘good’ weather as relevant to the specific experience. Conclusions: Solo experiences provide for well-being-related pathways in a multitude of ways, which highlights the well-being potential of solo implementation across practical fields beyond outdoor education, such as wilderness therapy, and environmental and planetary health initiatives. Future studies should continue to explore solo’s well-being potential in different settings, especially in the context of non-Western samples.

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National movement patterns during the COVID-19 pandemic in New Zealand: the unexplored role of neighbourhood deprivation

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-216108 ◽

2021 ◽

pp. jech-2020-216108 ◽

Cited By ~ 1

Author(s):

Malcolm Campbell ◽

Lukas Marek ◽

Jesse Wiki ◽

Matthew Hobbs ◽

Clive E Sabel ◽

...

Keyword(s):

New Zealand ◽

Mobile Phone ◽

Well Being ◽

Policy Debate ◽

Population Mobility ◽

Neighbourhood Deprivation ◽

Movement Data ◽

Spatial Inequalities ◽

The Impact

BackgroundThe COVID-19 pandemic has asked unprecedented questions of governments around the world. Policy responses have disrupted usual patterns of movement in society, locally and globally, with resultant impacts on national economies and human well-being. These interventions have primarily centred on enforcing lockdowns and introducing social distancing recommendations, leading to questions of trust and competency around the role of institutions and the administrative apparatus of state. This study demonstrates the unequal societal impacts in population movement during a national ‘lockdown’.MethodsWe use nationwide mobile phone movement data to quantify the effect of an enforced lockdown on population mobility by neighbourhood deprivation using an ecological study design. We then derive a mobility index using anonymised aggregated population counts for each neighbourhood (2253 Census Statistical Areas; mean population n=2086) of national hourly mobile phone location data (7.45 million records, 1 March 2020–20 July 2020) for New Zealand (NZ).ResultsCurtailing movement has highlighted and exacerbated underlying social and spatial inequalities. Our analysis reveals the unequal movements during ‘lockdown’ by neighbourhood socioeconomic status in NZ.ConclusionIn understanding inequalities in neighbourhood movements, we are contributing critical new evidence to the policy debate about the impact(s) and efficacy of national, regional or local lockdowns which have sparked such controversy.

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