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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 2

(594) Sleepiness in Pregnancy and Adverse Perinatal Outcomes

Thursday, January 30, 2025
4:00 PM – 6:00 PM  
Objective:

Sleep disorders in pregnancy have been associated with adverse perinatal outcomes (APO) including hypertensive disorders of pregnancy (HDP), preterm birth (PTB), and gestational diabetes mellitus (GDM), yet prospective studies that use validated tools to assess sleepiness in pregnancy are limited. We aimed to assess the association of sleepiness in pregnancy with APOs.

Study Design: In this secondary analysis of data from a large, diverse observational cohort of nulliparous individuals conducted at eight US medical centers, those with self-reported sleep data were included. Sleepiness was evaluated in early (6-13 weeks) and mid pregnancy (22-29 weeks) via the Epworth Sleepiness Scale, a validated tool to assess daytime sleep propensity, the ability to fall or stay asleep. Those with scores ≤10 were categorized as having no sleepiness (referent), 11-15 moderate sleepiness, and 16-24 severe sleepiness. The outcomes were HDP, GDM, PTB, and small-for-gestational-age birth < 10%ile (SGA). Multivariable logistic regression analysis was performed to evaluate the associations of moderate and severe sleepiness with each APO. A sensitivity analysis that included “high risk for sleep disordered breathing (SDB),” measured by an adapted Berlin Questionnaire for Sleep Apnea, as a covariate in the multivariable model was performed.

Results:

Of 6,806 eligible participants who completed sleep questionnaires at both time points, the average sleepiness score in early and mid pregnancy was 7.8 (SD 4.1) and 6.5 (SD 4.0) respectively. In early pregnancy, 20.0% and 4.3% of people experienced moderate and severe sleepiness, respectively; in mid pregnancy 14.4% and 2.5% experienced moderate and severe sleepiness. Severe sleepiness in mid-pregnancy was associated with GDM (aOR 1.78, 95% CI 1.01-3.12) and SGA (aOR 1.35, 95% CI 1.06-1.71) (Table). Findings were similar when accounting for SDB.

Conclusion:

Severe sleepiness during pregnancy, a symptom reflective of sleep quality, length, and often SDB, is associated with GDM and SGA suggesting a potential relationship with maternal glucose metabolism and placental function.