Does the duration of the mother's sleep contribute to stillbirth? – Medical Information Bulletin

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A new study published in the journal Birth whether maternal sleep is badociated with the risk of stillbirth.

Stillbirth is fetal death at or after 28 weeks of pregnancy. Risk factors for stillbirth include advanced age, obesity, smoking, pre-eclampsia, and diabetes during pregnancy. As an avoidable cause, several studies have been conducted in the past to reduce stillbirths.

Sleep disturbances carry risks of adverse consequences during pregnancy, such as growth restriction and premature growth. Researchers at the Consortium for the Study of Trends and Associated Risk for Stillbirth, in partnership with the Star Legacy Foundation and other parent support groups, recently conducted a study to infer the effect of sleep patterns maternal on stillbirth. This study was recently published in the journal Birth.

For the study, researchers conducted an online survey. This involved two groups; Women who were stillborn less than a month before the survey and the other group in late pregnancy or who had recently given birth (less than four weeks). A questionnaire was used to inquire about their nap times, nighttime sleep duration, number of awakenings, quality of sleep, medications used for sleeping. Their country of origin, race (Caucasian or not) was noted. The study excludes women under 18, those with more than one fetus, or the fetus with a conbad abnormality, and those who did not master the writing or reading of the fetus. ;English.

Mothers with a history of stillbirth had longer periods of sleep

Nighttime sleep was significantly longer in stillbirths. The duration of the naps was equal in both groups. The stillborn mothers did not wake up or wake up until once a night. Interestingly, these women had a better quality of sleep during the last month of pregnancy. Few studies have shown that the risk of stillbirth is higher when lying on your back. However, this study did not find such a correlation.

Waking up at night can be beneficial for mother and baby

Sleep disorders often occur during pregnancy, such as sleep-disordered breathing, short-term sleep, and poor sleep quality. These effects have been shown to have effects such as gestational hypertension, gestational diabetes, pre-eclampsia, fetal growth restriction, and premature birth.

Since blood pressure decreases during sleep, intermittent excitation during sleep causes an increase in nerve activity to increase blood pressure and is therefore beneficial. However, a long period of non-waking sleep results in prolonged hypotension. In addition to this, uninterrupted sleep is badociated with continuous compression of the vena cava, limiting blood flow to the fetus. Many mothers believed that babies died during the night.

The study ensures international coverage

One of the strengths of this study is the inclusion of women from different parts of the world. However, the vast majority of them were Caucasians. Non-Hispanic women had a higher risk of stillbirths. Further studies are needed to determine the racial influence on stillbirth.

The limitations of this study include inconsistencies in data collection because mothers had to remember the details. This was limited by involving women who were in late pregnancy during the study or who recently delivered stillbirths. There were no specific measured procedures such as polysomnography in the study that would provide more reliable data.

Maternal sleep plays an important role in fetal well-being

Louise O'Brien, co-author of this study, said, "Our findings are in addition to research indicating that maternal sleep plays a role in the well-being of the fetus. Studies to reduce stillbirths need to take into account the mother's sleep as this is a potentially modifiable risk factor. Understanding the role of maternal sleep could help us identify interventions that would allow us to better counsel women. "

Stillbirth has a huge devastating influence on the mother and the family. Although in many cases the cause is not known, it is possible to prevent it. Further research on risk factors for stillbirths should be undertaken. The neuronal and hormonal mechanism of maternal sleep contributing to stillbirth is a potential area requiring further research.

Written by Dr. Radhika Baitari, MS

References:

1. O'Brien L, Warland J, Stacey T, Heazell A, Mitchell E. Maternal Sleeping Practices and Stillbirth: Results of an International Case-Control Study. Birth. 2019;
2. Long periods of undisturbed sleep during pregnancy may be badociated with stillbirth [Internet]. EurekAlert! 2019 [cited 14 February 2019]. Available at the following address: https://eurekalert.org/pub_releases/2019-01/mm-u-lpo011719.php