Pei Yu Lee1, Li Hui Liu1, Cowan Ho1, Aloysius Jian Feng Ang1, Hui Xin Huang1, Oon-Hoe Teoh2, Kok-Hian Tan3, Yung Seng Lee4, Fabian Yap5, Joshua J Gooley6, Shiao-Yng Chan7, Shirong Cai8. 1. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore 119228. 2. Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Rd, Singapore 229899. 3. Duke-NUS Medical School, 8 College Rd, Singapore 169857; Division of Obstetrics and Gynaecology, KK Women's and Children's Hospital, 100 Bukit Timah Rd, Singapore 229899. 4. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Rd, Singapore 119228; Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 1E Kent Ridge Rd, Singapore 119228. 5. Department of Paediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Rd, Singapore 229899. 6. Program in Neuroscience and Behavioural Disorders, Duke-NUS Medical School, 8 College Rd, Singapore 169857; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore 119228. 7. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Rd, Singapore 119228. 8. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Rd, Singapore 119228. Electronic address: cai_shirong@sics.a-star.edu.sg.
Abstract
OBJECTIVES: The increasing prevalence of advanced maternal age (AMA) coupled with poor sleep quality among pregnant women makes it important to study their association with perinatal outcomes. However, little is known about the interaction of AMA and maternal antenatal sleep on perinatal outcomes. Here, we examined whether associations between AMA and perinatal outcomes are modified by antenatal sleep quality. PARTICIPANTS: Data were collected from 446 women, with a singleton pregnancy and no pregnancy complications, who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study. MEASUREMENTS: Participants completed the Pittsburgh Sleep Quality Index (PSQI) at 26-28 weeks gestation and had perinatal outcome data collected upon delivery. Interactions between AMA and maternal sleep quality on perinatal outcomes were investigated and where significant, analyses were further stratified by maternal age. All analyses were adjusted for maternal BMI at 26-28 weeks gestation, ethnicity, and maternal education. RESULTS: Neonates of mothers of AMA and poor sleep quality (PSQI score >5) had increased odds of stay in the neonatal intensive care unit (adjusted odds ratio = 3.53, 95% CI: -1.21 to 10.27) and shorter birth length (adjusted mean difference = -1.05 cm, 95% CI: -1.82 to -0.20), as compared with women of AMA and good sleep quality (PSQI score ≤5). In women <35 years, sleep quality did not associate with perinatal outcomes. CONCLUSION: Poor sleep quality in women of AMA was associated with neonatal health outcomes. Improving maternal antenatal sleep may potentially improve perinatal outcomes in offspring of women of AMA.
OBJECTIVES: The increasing prevalence of advanced maternal age (AMA) coupled with poor sleep quality among pregnant women makes it important to study their association with perinatal outcomes. However, little is known about the interaction of AMA and maternal antenatal sleep on perinatal outcomes. Here, we examined whether associations between AMA and perinatal outcomes are modified by antenatal sleep quality. PARTICIPANTS: Data were collected from 446 women, with a singleton pregnancy and no pregnancy complications, who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study. MEASUREMENTS: Participants completed the Pittsburgh Sleep Quality Index (PSQI) at 26-28 weeks gestation and had perinatal outcome data collected upon delivery. Interactions between AMA and maternal sleep quality on perinatal outcomes were investigated and where significant, analyses were further stratified by maternal age. All analyses were adjusted for maternal BMI at 26-28 weeks gestation, ethnicity, and maternal education. RESULTS: Neonates of mothers of AMA and poor sleep quality (PSQI score >5) had increased odds of stay in the neonatal intensive care unit (adjusted odds ratio = 3.53, 95% CI: -1.21 to 10.27) and shorter birth length (adjusted mean difference = -1.05 cm, 95% CI: -1.82 to -0.20), as compared with women of AMA and good sleep quality (PSQI score ≤5). In women <35 years, sleep quality did not associate with perinatal outcomes. CONCLUSION: Poor sleep quality in women of AMA was associated with neonatal health outcomes. Improving maternal antenatal sleep may potentially improve perinatal outcomes in offspring of women of AMA.