Poor Sleep Quality Is Associated with Higher Hemoglobin A1c in Pregnant Women: A Pilot Observational Study

We hypothesized that poor sleep quality exacerbates glucose intolerance manifested as elevated glycosylated hemoglobin (HbA1c), which increases the risk for gestational diabetes. To test this, 38 pregnant and 22 non-pregnant (age, 18–35 years; body-mass index, 20–35 kg/m2) otherwise healthy women were enrolled in the study. Sleep quality was assessed during gestational week 24 (pregnant), or outside of the menstrual period (non-pregnant), using qualitative (Pittsburgh Sleep Quality Index) and objective (actigraphic wrist-watch) measures. Blood glucose, total cortisol, and depression status were evaluated. Eight pregnant and one non-pregnant women were lost to follow-up, or withdrew from the study. There was a higher incidence of poor sleep quality in pregnant (73%) relative to non-pregnant women (43%). Although actigraphic data revealed no differences in actual sleep hours between pregnant and non-pregnant women, the number of wake episodes and sleep fragmentation were higher in pregnant women. Poor sleep quality was positively correlated with higher HbA1c in both pregnant (r = 0.46, n = 26, p = 0.0151) and non-pregnant women (r = 0.50, n = 19, p = 0.0217), reflecting higher average blood glucose concentrations. In contrast, poor sleep was negatively correlated with cortisol responses in pregnant women (r = −0.46, n = 25, p = 0.0167). Three pregnant women had elevated one-hour oral glucose tolerance test results (>153 mg/dL glucose). These same pregnant women exhibited poor sleep quality. These results support the suggestion that poor sleep quality is an important risk factor that is associated with glucose intolerance and attendant health complications in pregnancy.

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Relationship Between Sleep Quality, Depression Symptoms, and Blood Glucose in Pregnant Women

Western Journal of Nursing Research ◽

10.1177/0193945918809714 ◽

2018 ◽

Vol 41 (9) ◽

pp. 1222-1240 ◽

Cited By ~ 7

Author(s):

Azza H. Ahmed ◽

Sun Hui ◽

Jennifer Crodian ◽

Karen Plaut ◽

David Haas ◽

...

Keyword(s):

Blood Glucose ◽

Sleep Quality ◽

Pregnant Women ◽

Quality Data ◽

Depression Symptoms ◽

Poor Sleep ◽

Maternal Child Health ◽

Work Schedule ◽

Poor Sleep Quality ◽

Prospective Longitudinal

Sleep quality during pregnancy affects maternal/child health. We aimed to assess changes in sleep quality during pregnancy and determine its relationship to maternal mood, blood glucose, and work schedule among primiparous women. We conducted a prospective/longitudinal/observational study. Ninety-two pregnant women were recruited from Midwestern hospital. Mood and sleep quality data were collected using Edinburgh Postnatal Depression Scale/Pittsburgh Sleep Quality Index at Gestational Weeks 22 and 32. Forty-three women completed the study. Twenty-six women (63%) were African American and the mean age was 23.64 ( SD = 3.82) years. Rate of poor sleep quality increased during pregnancy with 25% of women had scores indicative of depression symptoms. Poor sleep quality score was related to mood scores ( p < .05) and work schedule. Blood glucose was not significantly related to sleep duration. In conclusion, poor sleep quality during pregnancy was associated with poor mood and work schedule, suggesting that interventions targeting mental health and lifestyles are needed.

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Poor sleep quality, antepartum depression and suicidal ideation among pregnant women

Journal of Affective Disorders ◽

10.1016/j.jad.2016.11.020 ◽

2017 ◽

Vol 209 ◽

pp. 195-200 ◽

Cited By ~ 26

Author(s):

Bizu Gelaye ◽

Gifty Addae ◽

Beemnet Neway ◽

Gloria T. Larrabure-Torrealva ◽

Chunfang Qiu ◽

...

Keyword(s):

Suicidal Ideation ◽

Sleep Quality ◽

Pregnant Women ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Antepartum Depression

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Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in China

10.21203/rs.2.13204/v1 ◽

2019 ◽

Author(s):

Ming Gao ◽

Jiajin Hu ◽

Liu Yang ◽

Ning Ding ◽

Xiaotong Wei ◽

...

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Postnatal Depression ◽

Regression Models ◽

Antenatal Depression ◽

Poor Sleep ◽

Second Trimester ◽

Poor Sleep Quality ◽

Depression Status ◽

Antenatal Stress

Abstract Background: Sleep quality in the third trimester of pregnant women is related to mental health. However, There is still a lack of large-scale cohort research in the second trimester to confirms this relationship. We aim to assess the associations of sleep quality during the second trimester with antenatal stress and antenatal and postnatal depression. Methods: We examined 1152 pregnant women from a prospective cohort study in China to assess the associations of sleep quality in the second trimester with antenatal stress, antenatal depression, and postnatal depression. We used linear regression models and logistic regression models to examine the associations of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) during pregnancy with perinatal stress (Pregnancy Pressure Scale [PPS]) and depression (Edinburgh Postnatal Depression Scale [EPDS]) status. We further assessed the relationship in groups divided according to age. Results: PSQI scores were positively associated with antenatal PPS scores (β: 1.52, 95% confidence interval [CI]: 1.28, 1.76), antenatal EPDS scores (β: 0.68, 95% CI: 0.58, 0.78), and postpartum EPDS scores (β: 0.51, 95% CI: 0.38, 0.64). Poor sleep quality was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression status (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression status (OR: 2.40, 95% CI: 1.58, 3.64). The association of sleep quality in the second trimester with depression status was found in women older than 30 years old (OR: 4.12, 95% CI: 2.18, 7.78) and not in women younger than 30 years old. Conclusion: Poor sleep quality in the second trimester among Chinese pregnant women is associated with stress and depression symptoms. Strategies to boost sleep quality should be considered during prenatal health care to improve women’s mental health status.

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Sleep quality and associated factors among pregnant women attending antenatal care at Jimma Medical Center, Jimma, Southwest Ethiopia, 2020: cross-sectional study

BMC Psychiatry ◽

10.1186/s12888-021-03483-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tamrat Anbesaw ◽

Habtamu Abebe ◽

Chalachew Kassaw ◽

Tilahun Bete ◽

Alemayehu Molla

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Associated Factors ◽

Medical Center ◽

Cross Sectional Study ◽

Poor Sleep ◽

Sectional Study ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Southwest Ethiopia

Abstract Background Sleep is a natural physiological process vital for the physical and mental wellbeing of pregnant women and their fetuses. Even though poor sleep quality is a common problem among pregnant women, it is not studied in developing countries including Ethiopia. Therefore, this study was aimed to assess the poor sleep quality and associated factors among pregnant women attending antenatal care at Jimma medical center, Jimma, Southwest Ethiopia, 2020. Methods A cross-sectional study design was conducted among 415 pregnant women at Jimma Medical Center (JMC). The study subjects were selected using a systematic random sampling technique. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality using face-to-face interviews. SPSS version 25 was used to analyze data. Bivariate and multivariable logistic regressions were done to identify factors related to sleep quality. In multivariable logistic regression variables with a p-value less than 0.05 was considered significant and, adjusted OR (AOR) with 95% CI was used to present the strength of the association. Results The prevalence of poor sleep quality among pregnant women was found to be 30.8% (95% CI (26.5, 35.2). In multivariable analysis, age ≥ 30 years old (AOR = 1.94;95%CI:1.03,3.66), Multigravida (AOR = 1.90;95%CI:1.90,3.32),depression (AOR = 4.26;95%CI:2.54,7.14),stress (AOR = 1.85;95%CI:1.20,3.02) were variables significantly associated with poor sleep quality. Conclusion This study found a high prevalence of poor sleep quality among pregnant women. Older age, gravidity, depression, and stress were associated with poor sleep quality. It is better to have routine sleep pattern screening and teach sleep hygiene practice for pregnant women.

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Social Media Use, Unhealthy Lifestyles, and the Risk of Miscarriage Among Pregnant Women During the COVID-19 Pandemic: Prospective Observational Study

JMIR Public Health and Surveillance ◽

10.2196/25241 ◽

2021 ◽

Vol 7 (1) ◽

pp. e25241

Author(s):

Xiaotong Zhang ◽

Jue Liu ◽

Na Han ◽

Jing Yin

Keyword(s):

Physical Activity ◽

Social Media ◽

Sleep Quality ◽

Pregnant Women ◽

Dietary Diversity ◽

Media Use ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Social Media Use ◽

The Impact

Background The COVID-19 pandemic has resulted in changes to normal life and disrupted social and economic function worldwide. However, little is known about the impact of social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women during the COVID-19 pandemic. Objective This study aims to assess the association between social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women in the early stage of the COVID-19 pandemic in China. Methods In this prospective cohort study, 456 singleton pregnant women in mainland China were recruited during January and February 2020. Sociodemographic characteristics, history of previous health, social media use, and current lifestyles were collected at baseline, and we followed up about the occurrence of miscarriage. Log-binomial regression models were used to estimate the risk ratios (RRs) of miscarriage for women with different exposures to COVID-19–specific information. Results Among all the 456 pregnant women, there were 82 (18.0%) who did no physical activities, 82 (18.0%) with inadequate dietary diversity, 174 (38.2%) with poor sleep quality, and 54 (11.8%) spending >3 hours on reading COVID-19 news per day. Women with excessive media use (>3 hours) were more likely to be previously pregnant (P=.03), have no physical activity (P=.003), have inadequate dietary diversity (P=.03), and have poor sleep quality (P<.001). The prevalence of miscarriage was 16.0% (n=73; 95% CI 12.6%-19.4%). Compared with women who spent 0.5-2 hours (25/247, 10.1%) on reading COVID-19 news per day, miscarriage prevalence in women who spent <0.5 hours (5/23, 21.7%), 2-3 hours (26/132, 19.7%), and >3 hours (17/54, 31.5%) was higher (P<.001). Miscarriage prevalence was also higher in pregnant women with poor sleep quality (39/174, 22.4% vs 34/282, 12.1%; P=.003) and a high education level (66/368, 17.9% vs 7/88, 8.0%; P=.02). In the multivariable model, poor sleep quality (adjusted RR 2.06, 95% CI 1.24-3.44; P=.006), 2-3 hours of media use daily (adjusted RR 1.74, 95% CI 1.02-2.97; P=.04), and >3 hours of media use daily (adjusted RR 2.56, 95% CI 1.43-4.59; P=.002) were associated with miscarriage. In the sensitivity analysis, results were still stable. Conclusions Pregnant women with excessive media use were more likely to have no physical activity, inadequate dietary diversity, and poor sleep quality. Excessive media use and poor sleep quality were associated with a higher risk of miscarriage. Our findings highlight the importance of healthy lifestyles during the COVID-19 pandemic.

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Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in China

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2583-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Ming Gao ◽

Jiajin Hu ◽

Liu Yang ◽

Ning Ding ◽

Xiaotong Wei ◽

...

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Postnatal Depression ◽

Regression Models ◽

Antenatal Depression ◽

Poor Sleep ◽

Second Trimester ◽

Poor Sleep Quality ◽

Depression Status ◽

Antenatal Stress

Abstract Background The sleep quality of pregnant women in the third trimester is related to mental health. However, there is still a lack of large-scale cohort research exploring this relationship in the second trimester. Thus, we assessed the associations of sleep quality during the second trimester with antenatal stress and antenatal and postnatal depression. Methods We examined 1152 pregnant women from a prospective cohort study in China to assess the associations of sleep quality in the second trimester with antenatal stress, antenatal depression, and postnatal depression. We used linear regression models and logistic regression models to examine the associations of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) during pregnancy with perinatal stress (Pregnancy Pressure Scale [PPS]) and depression (Edinburgh Postnatal Depression Scale [EPDS]) status. We further assessed the relationship in groups divided according to maternal age. Results PSQI scores were positively associated with antenatal PPS scores (β: 1.52, 95% confidence interval [CI]: 1.28, 1.76), antenatal EPDS scores (β: 0.68, 95% CI: 0.58, 0.78), and postpartum EPDS scores (β: 0.51, 95% CI: 0.38, 0.64). Poor sleep quality (PSQI scores ≥5) was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression status (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression status (OR: 2.40, 95% CI: 1.58, 3.64) after adjusting maternal age, BMI, gestational age, smoking, educational level, annual household income and social support. The association of poor sleep quality (PSQI scores ≥5) in the second trimester with postnatal depression status was significant among women more than or equal to 30 years old (OR: 4.12, 95% CI: 2.18, 7.78) but not among women less than 30 years old after adjusting covariates above. Conclusion Poor sleep quality in the second trimester among Chinese pregnant women is associated with stress and depression symptoms. Strategies to boost sleep quality should be considered during prenatal health care to improve women’s mental health status.

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Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in China

10.21203/rs.2.13204/v3 ◽

2019 ◽

Author(s):

Ming Gao ◽

Jiajin Hu ◽

Liu Yang ◽

Ning Ding ◽

Xiaotong Wei ◽

...

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Postnatal Depression ◽

Regression Models ◽

Antenatal Depression ◽

Poor Sleep ◽

Second Trimester ◽

Poor Sleep Quality ◽

Depression Status ◽

Antenatal Stress

Abstract Background: The sleep quality of pregnant women in the third trimester is related to mental health. However, there is still a lack of large-scale cohort research exploring this relationship in the second trimester. Thus, we assessed the associations of sleep quality during the second trimester with antenatal stress and antenatal and postnatal depression. Methods: We examined 1152 pregnant women from a prospective cohort study in China to assess the associations of sleep quality in the second trimester with antenatal stress, antenatal depression, and postnatal depression. We used linear regression models and logistic regression models to examine the associations of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) during pregnancy with perinatal stress (Pregnancy Pressure Scale [PPS]) and depression (Edinburgh Postnatal Depression Scale [EPDS]) status. We further assessed the relationship in groups divided according to maternal age. Results: PSQI scores were positively associated with antenatal PPS scores (β: 1.52, 95% confidence interval [CI]: 1.28, 1.76), antenatal EPDS scores (β: 0.68, 95% CI: 0.58, 0.78), and postpartum EPDS scores (β: 0.51, 95% CI: 0.38, 0.64). Poor sleep quality (PSQI scores ≥ 5) was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression status (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression status (OR: 2.40, 95% CI: 1.58, 3.64) after adjusting maternal age, BMI, gestational age, smoking, educational level, annual household income and social support. The association of poor sleep quality (PSQI scores ≥ 5) in the second trimester with postnatal depression status was significant among women more than or equal to 30 years old (OR: 4.12, 95% CI: 2.18, 7.78) but not among women less than 30 years old after adjusting covariates above. Conclusion: Poor sleep quality in the second trimester among Chinese pregnant women is associated with stress and depression symptoms. Strategies to boost sleep quality should be considered during prenatal health care to improve women’s mental health status.

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Social Media Use, Unhealthy Lifestyles, and the Risk of Miscarriage Among Pregnant Women During the COVID-19 Pandemic: Prospective Observational Study (Preprint)

10.2196/preprints.25241 ◽

2020 ◽

Author(s):

Xiaotong Zhang ◽

Jue Liu ◽

Na Han ◽

Jing Yin

Keyword(s):

Physical Activity ◽

Social Media ◽

Sleep Quality ◽

Pregnant Women ◽

Dietary Diversity ◽

Media Use ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Social Media Use ◽

The Impact

BACKGROUND The COVID-19 pandemic has resulted in changes to normal life and disrupted social and economic function worldwide. However, little is known about the impact of social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women during the COVID-19 pandemic. OBJECTIVE This study aims to assess the association between social media use, unhealthy lifestyles, and the risk of miscarriage among pregnant women in the early stage of the COVID-19 pandemic in China. METHODS In this prospective cohort study, 456 singleton pregnant women in mainland China were recruited during January and February 2020. Sociodemographic characteristics, history of previous health, social media use, and current lifestyles were collected at baseline, and we followed up about the occurrence of miscarriage. Log-binomial regression models were used to estimate the risk ratios (RRs) of miscarriage for women with different exposures to COVID-19–specific information. RESULTS Among all the 456 pregnant women, there were 82 (18.0%) who did no physical activities, 82 (18.0%) with inadequate dietary diversity, 174 (38.2%) with poor sleep quality, and 54 (11.8%) spending >3 hours on reading COVID-19 news per day. Women with excessive media use (>3 hours) were more likely to be previously pregnant (P=.03), have no physical activity (P=.003), have inadequate dietary diversity (P=.03), and have poor sleep quality (P<.001). The prevalence of miscarriage was 16.0% (n=73; 95% CI 12.6%-19.4%). Compared with women who spent 0.5-2 hours (25/247, 10.1%) on reading COVID-19 news per day, miscarriage prevalence in women who spent <0.5 hours (5/23, 21.7%), 2-3 hours (26/132, 19.7%), and >3 hours (17/54, 31.5%) was higher (P<.001). Miscarriage prevalence was also higher in pregnant women with poor sleep quality (39/174, 22.4% vs 34/282, 12.1%; P=.003) and a high education level (66/368, 17.9% vs 7/88, 8.0%; P=.02). In the multivariable model, poor sleep quality (adjusted RR 2.06, 95% CI 1.24-3.44; P=.006), 2-3 hours of media use daily (adjusted RR 1.74, 95% CI 1.02-2.97; P=.04), and >3 hours of media use daily (adjusted RR 2.56, 95% CI 1.43-4.59; P=.002) were associated with miscarriage. In the sensitivity analysis, results were still stable. CONCLUSIONS Pregnant women with excessive media use were more likely to have no physical activity, inadequate dietary diversity, and poor sleep quality. Excessive media use and poor sleep quality were associated with a higher risk of miscarriage. Our findings highlight the importance of healthy lifestyles during the COVID-19 pandemic.

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THE RELATION BETWEEN QUALITY AND QUANTITY OF SLEEP WITH BLOOD GLUCOSE LEVELS IN WOMEN CHILDBEARING AGE

Indonesian Midwifery and Health Sciences Journal ◽

10.20473/imhsj.v4i1.2020.1-7 ◽

2021 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Afdhila Istigfarin ◽

Bambang Purwanto ◽

Ashon Sa’adi

Keyword(s):

Blood Glucose ◽

Sleep Quality ◽

Normal Blood ◽

P Value ◽

Poor Sleep ◽

Childbearing Age ◽

Poor Sleep Quality ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Normal Blood Glucose

Abstract Background: The quality and quantity of sleep can affect blood glucose levels, so it is at risk of hyperglycemia. Hyperglycemia in women childbearing age can affect the cycle of menstruation and fertility. Based on previous research shows that more than half of students have poor sleep quality and found an increase in blood glucose levels in students who sleep less than 7 hours. This study aims to analyze the relationship between quality and quantity of sleep with blood glucose levels in women of childbearing age. Methods: This research method was observational analytic with cross sectional design. The number of samples was 43 students with a purposive sampling technique. The independent variable is the quality and quantity of sleep measured using the PSQI questionnaire, while the dependent variable is the blood glucose level which is checked during fasting for at least 8 hours. Analysis using the spearman rho statistical test. Results: The results showed that 27.9% of students had good sleep quality, including 4.6% with low blood glucose levels and 23.3% with normal blood glucose levels. 72.1% of students have poor sleep quality, including 65.1% with normal blood glucose levels and 7% with high blood glucose levels. The results of the analysis between sleep quality with blood glucose levels obtained rs = 0.345 and p value = 0.023, while the quantity of sleep with blood glucose levels obtained rs = 0.359 and p value = 0.018. Conclusions: The quality and quantity of sleep is significantly associated with blood glucose levels. Women childbearing age should maintain quality and quantity of sleep to prevent increased blood glucose levels. Health workers need to pay attention to the quality and quantity of patient’s sleep especially in women childbearing age.

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Continuous glucose monitoring in obese pregnant women with no hyperglycemia on glucose tolerance test

PLoS ONE ◽

10.1371/journal.pone.0253047 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253047

Author(s):

Rosa Maria Rahmi ◽

Priscila de Oliveira ◽

Luciano Selistre ◽

Paulo Cury Rezende ◽

Gabriela Neuvald Pezzella ◽

...

Keyword(s):

Blood Glucose ◽

Glucose Tolerance ◽

Pregnant Women ◽

Continuous Glucose Monitoring ◽

Glucose Tolerance Test ◽

Glucose Monitoring ◽

Tolerance Test ◽

Oral Glucose ◽

Glucose Levels ◽

Blood Glucose Levels

Objective The objective of the present study was to compare 24-hour glycemic levels between obese pregnant women with normal glucose tolerance and non-obese pregnant women. Methods In the present observational, longitudinal study, continuous glucose monitoring was performed in obese pregnant women with normal oral glucose tolerance test with 75 g of glucose between the 24th and the 28th gestational weeks. The control group (CG) consisted of pregnant women with normal weight who were selected by matching the maternal age and parity with the same characteristics of the obese group (OG). Glucose measurements were obtained during 72 hours. Results Both the groups were balanced in terms of baseline characteristics (age: 33.5 [28.7–36.0] vs. 32.0 [26.0–34.5] years, p = 0.5 and length of pregnancy: 25.0 [24.0–25.0] vs. 25.5 [24.0–28.0] weeks, p = 0.6 in the CG and in the OG, respectively). Pre-breakfast glycemic levels were 77.77 ± 10.55 mg/dL in the CG and 82.02 ± 11.06 mg/dL in the OG (p<0.01). Glycemic levels at 2 hours after breakfast were 87.31 ± 13.10 mg/dL in the CG and 93.48 ± 18.74 mg/dL in the OG (p<0.001). Daytime blood glucose levels were 87.6 ± 15.4 vs. 93.1 ± 18.3 mg/dL (p<0.001) and nighttime blood glucose levels were 79.3 ± 15.8 vs. 84.7 ± 16.3 mg/dL (p<0.001) in the CG and in the OG, respectively. The 24-hour, daytime, and nighttime values of the area under the curve were higher in the OG when compared with the CG (85.1 ± 0.16 vs. 87.9 ± 0.12, 65.6 ± 0.14 vs. 67.5 ± 0.10, 19.5 ± 0.07 vs. 20.4 ± 0.05, respectively; p<0.001). Conclusion The results of the present study showed that obesity in pregnancy was associated with higher glycemic levels even in the presence of normal findings on glucose tolerance test.

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