Poster Session 3
Naima E. Ross, MD (she/her/hers)
Maternal Fetal Medicine Fellow
NYU Grossman School of Medicine
New York, New York, United States
Rebecca J. Baer, MS
Research Analyst
University of California San Francisco School of Medicine
San Francisco, California, United States
Scott P. Oltman, MS
Epidemiologist
University of California San Francisco School of Medicine
San Francisco, California, United States
Dana R. Gossett, MD, MSCI
Professor and Chair, Department of Obstetrics and Gynecology
NYU Langone Health
New York, New York, United States
Rashmi N. Aurora, MD
Associate Professor
NYU Langone Health
New York, New York, United States
Laura L. Jelliffe-Pawlowski, PhD
Epidemiology and Biostatistics Professor
NYU Langone Health
New York, New York, United States
Justin S. Brandt, MD (he/him/his)
Associate Professor, Division Director, Fellowship Program Director
NYU Langone Health
New York, New York, United States
Sleep disorders, such as insomnia and obstructive sleep apnea (OSA), are associated with pregnancy complications. In this study, we aimed to determine the impact of insomnia on the risk of severe morbidity (SM) and to compare the magnitude of the associations between insomnia/OSA and SM.
We performed a cross-sectional study of liveborn singleton births in California (2011-2020). Birth certificates were linked to hospital discharge records for birthing people and their infants. Insomnia and OSA were identified as exposures using ICD-9 and 10 codes. The primary outcome was SM, as defined by the US Centers for Disease Control and Prevention. Secondary outcomes included components of SM. The relative risks, and corresponding 95% confidence intervals (CI), were calculated for outcomes by sleep disorder using Poisson regression models.
During the study period, there were 4,145,166 singleton live births with linked records. The prevalence of insomnia and OSA were 117.4 and 138 per 1000 live births, respectively. Among people with sleep disorders, only 72 had both diagnoses (0.7%). Compared to people with no sleep disorders (reference), a higher percentage of people with sleep disorders were age >35 years, White, privately-insured, BMI >30 kg/m2, and had cesarean deliveries. The RR of SM was 3.4 fold higher (95% CI 3.1, 3.8) and 4.3 fold higher (95% CI 3.9, 4.6) for those with insomnia and OSA, respectively (Table). This risk of SM was even greater for non-transfusion SM. The magnitude of risk for disseminated intravascular coagulation, puerperal cerebrovascular disorders, sepsis, shock, and hysterectomy was slightly higher for patients with insomnia versus those with OSA (Table). The magnitude of risk for all other components of SM was greater in OSA versus insomnia.
While both insomnia and OSA confer an increased risk for SM, they are associated with distinct demographic traits. Further study is need to identify baseline patient characteristics associated with each of these sleep disorders during pregnancy and to design targeted preventative interventions.
