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CME Credit Offered
CME Credit Offered
Abstract Award
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Poster Session 1

(301) Risk of ischemic placental disease in pregnant individuals with insomnia

Thursday, January 30, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Naima E. Ross, MD (she/her/hers)

    Maternal Fetal Medicine Fellow
    NYU Grossman School of Medicine
    New York, New York, United States

    • Coauthor(s)

  • RB

    Rebecca J. Baer, MS

    Research Analyst
    University of California San Francisco School of Medicine
    San Francisco, California, United States

  • SO

    Scott P. Oltman, MS

    Epidemiologist
    University of California San Francisco School of Medicine
    San Francisco, California, United States

  • RA

    Rashmi N. Aurora, MD

    Associate Professor
    NYU Langone Health
    New York, New York, United States

  • DG

    Dana R. Gossett, MD, MSCI

    Professor and Chair, Department of Obstetrics and Gynecology
    NYU Langone Health
    New York, New York, United States

  • LJ

    Laura L. Jeliffe-Pawlowski, PhD

    Professor of Epidemiology & Biostatistics
    University of California San Francisco School of Medicine
    San Francisco, California, 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

Objective:
While obstructive sleep apnea (OSA) is known to be associated with ischemic placental disease (IPD), we sought to ascertain the association between insomnia and IPD and to compare the magnitude of the associations between these sleep disorders and IPD.

Study Design:
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 using ICD-9 and 10 codes. The primary outcome was IPD, defined as hypertensive disorders of pregnancy (HDP), placental abruption, and small for gestational age (SGA) birth. Secondary outcomes included components of IPD and preterm birth. The relative risks and corresponding 95% confidence intervals (CI) were reported by sleep disorders using Poisson regression models.

Results:
During the study period, there were 4,145,166 singleton live births with linked hospital and neonatal records. People with sleep disorders in pregnancy were predominantly age 18-34 at delivery, Hispanic, well educated, and BMI 18.5 to < 25 kg/m2 (Table 1). There was minimal overlap between sleep disorder groups; only 72 (0.7%) of 10,497 patients with sleep disorders had comorbid insomnia and OSA. Patients with insomnia had higher rates of tobacco smoking (13.6% vs 6.6%) and depression (29.6% vs 17.1%) compared to those with OSA. Compared to patients with no sleep disorders, the risk of IPD was 1.7 fold higher (95% CI 1.6, 1.7) for those with insomnia and 1.8 fold higher (95% CI 1.8, 1.9) for those with OSA. The risk of IPD was 2.2 fold higher for those with comorbid insomnia and OSA (95% CI 1.5, 3.2). The magnitude of risk for abruption and SGA birth was greater for insomnia versus OSA, but the magnitude of risk was comparable for the other components of IPD and preterm birth (Table 2).

Conclusion:
Similar to OSA, insomnia is associated with an increased risk for IPD and its components, especially abruption and SGA birth. Further study is needed to determine if identification and treatment of insomnia may prevent adverse pregnancy outcomes.