Association between adverse perinatal outcomes and sleep disturbances during pregnancy: a systematic review and meta-analysis

Abstract

Background

Due to physiological and hormonal factors, sleep disturbances are prevalent in the obstetric population. Multiple studies have evaluated the relationship between sleep disturbances and perinatal outcomes, with inconsistent results. The purpose of this systematic review and meta-analysis was to further assess the overall relationship between four types of sleep disturbances (snoring, obstructive sleep apnea, extreme sleep duration, and poor sleep quality) and adverse perinatal outcomes.

Methods

We performed electronic searches in PubMed, Embase, the Cochrane Library, CNKI, VIP, and Wanfang Data in February 2019 to identify studies that assessed adverse perinatal outcomes among expectant mothers with sleep disturbances.

Results

In total, 5044 studies were identified in the initial search and 65 met the defined criteria. Pooled analysis showed that sleep disturbances were associated with an increased risk for preeclampsia (aOR: 2.77; 95% CI: 1.81–4.24), gestational diabetes mellitus (aOR: 1.96; 95% CI: 1.62–2.38), cesarean delivery (aOR: 1.99; 95% CI: 1.70–2.33), depression (aOR: 3.98; 95% CI: 2.74–5.77) and preterm birth (aOR: 1.95; 95% CI: 1.55–2.45).

Conclusions

The four studied sleep disturbances (OSA, snoring, extreme sleep duration and poor sleep quality) during pregnancy were associated with adverse perinatal outcomes. Expectant mothers should be advised to practice healthy sleep hygiene measures.

Keywords:

• Sleep disturbances
• pregnancy
• meta-analysis
• systematic review

Acknowledgment

We would like to thank Miss. Wang Min, at North Sichuan Medical College for her assistance with preparing the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

Additional information

Funding

This research was supported by the Chongqing Science and Technology Bureau of the People’s Republic of China under grant No. cstc2017jcyjAX0004, and the Scientific Research and Innovation Experiment Project of Chongqing Medical University under grant No. SRIEP201957.