Association between maternal sleep practices and late stillbirth - findings from a stillbirth case-control study

Alexander EP Heazell, Minglan Li, J Budd, JMD Thompson, T Stacey, Robin S Cronin, Bill Martin, Devender Roberts, EA Mitchell, LME McCowan

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: To report maternal sleep practices in women who experienced a stillbirth compared with controls with ongoing live pregnancies at similar gestation.
Design: Prospective case‐control study.
Setting: Forty‐one maternity units in the United Kingdom.
Population: Women who had a stillbirth after ≥ 28 weeks’ gestation (n = 291) and women with an ongoing pregnancy at the time of interview (n = 733).
Methods: Data were collected using an interviewer‐administered questionnaire that included questions on maternal sleep practices before pregnancy, in the four weeks prior to, and on the night before the interview/stillbirth.
Main outcome measures: Maternal sleep practices during pregnancy.
Results: In multivariable analysis, supine going‐to‐sleep position the night before stillbirth had a 2.3‐fold increased risk of late stillbirth [adjusted Odds Ratio (aOR) 2.31, 95% CI 1.04–5.11] compared with the left side. In addition, women who had a stillbirth were more likely to report sleep duration less than 5.5 hours on the night before stillbirth (aOR 1.83, 95% CI 1.24–2.68), getting up to the toilet once or less (aOR 2.81, 95% CI 1.85–4.26), and a daytime nap every day (aOR 2.22, 95% CI 1.26–3.94). No interaction was detected between supine going‐to‐sleep position and a small‐for‐gestational‐age infant, maternal body mass index, or gestational age. The population‐attributable risk for supine going‐to‐sleep position was 3.7% (95% CI 0.5–9.2).
Conclusions: This study confirms that supine going‐to‐sleep position is associated with late stillbirth. Further work is required to determine whether intervention(s) can decrease the frequency of supine going‐to‐sleep position and the incidence of late stillbirth.
Original languageEnglish
Pages (from-to)254-262
Number of pages9
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume125
Issue number2
Early online date20 Nov 2017
DOIs
Publication statusPublished - Jan 2018
Externally publishedYes

Fingerprint

Stillbirth
Case-Control Studies
Sleep
Mothers
Supine Position
Pregnancy
Odds Ratio
Interviews
Gestational Age
Body Mass Index
Outcome Assessment (Health Care)
Prospective Studies
Incidence

Cite this

Heazell, Alexander EP ; Li, Minglan ; Budd, J ; Thompson, JMD ; Stacey, T ; Cronin, Robin S ; Martin, Bill ; Roberts, Devender ; Mitchell, EA ; McCowan, LME. / Association between maternal sleep practices and late stillbirth - findings from a stillbirth case-control study. In: BJOG: An International Journal of Obstetrics and Gynaecology. 2018 ; Vol. 125, No. 2. pp. 254-262.
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title = "Association between maternal sleep practices and late stillbirth - findings from a stillbirth case-control study",
abstract = "Objective: To report maternal sleep practices in women who experienced a stillbirth compared with controls with ongoing live pregnancies at similar gestation.Design: Prospective case‐control study.Setting: Forty‐one maternity units in the United Kingdom.Population: Women who had a stillbirth after ≥ 28 weeks’ gestation (n = 291) and women with an ongoing pregnancy at the time of interview (n = 733).Methods: Data were collected using an interviewer‐administered questionnaire that included questions on maternal sleep practices before pregnancy, in the four weeks prior to, and on the night before the interview/stillbirth.Main outcome measures: Maternal sleep practices during pregnancy.Results: In multivariable analysis, supine going‐to‐sleep position the night before stillbirth had a 2.3‐fold increased risk of late stillbirth [adjusted Odds Ratio (aOR) 2.31, 95{\%} CI 1.04–5.11] compared with the left side. In addition, women who had a stillbirth were more likely to report sleep duration less than 5.5 hours on the night before stillbirth (aOR 1.83, 95{\%} CI 1.24–2.68), getting up to the toilet once or less (aOR 2.81, 95{\%} CI 1.85–4.26), and a daytime nap every day (aOR 2.22, 95{\%} CI 1.26–3.94). No interaction was detected between supine going‐to‐sleep position and a small‐for‐gestational‐age infant, maternal body mass index, or gestational age. The population‐attributable risk for supine going‐to‐sleep position was 3.7{\%} (95{\%} CI 0.5–9.2).Conclusions: This study confirms that supine going‐to‐sleep position is associated with late stillbirth. Further work is required to determine whether intervention(s) can decrease the frequency of supine going‐to‐sleep position and the incidence of late stillbirth.",
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Heazell, AEP, Li, M, Budd, J, Thompson, JMD, Stacey, T, Cronin, RS, Martin, B, Roberts, D, Mitchell, EA & McCowan, LME 2018, 'Association between maternal sleep practices and late stillbirth - findings from a stillbirth case-control study', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 125, no. 2, pp. 254-262. https://doi.org/10.1111/1471-0528.14967

Association between maternal sleep practices and late stillbirth - findings from a stillbirth case-control study. / Heazell, Alexander EP; Li, Minglan; Budd, J; Thompson, JMD; Stacey, T; Cronin, Robin S; Martin, Bill; Roberts, Devender; Mitchell, EA; McCowan, LME.

In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 125, No. 2, 01.2018, p. 254-262.

Research output: Contribution to journalArticle

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T1 - Association between maternal sleep practices and late stillbirth - findings from a stillbirth case-control study

AU - Heazell, Alexander EP

AU - Li, Minglan

AU - Budd, J

AU - Thompson, JMD

AU - Stacey, T

AU - Cronin, Robin S

AU - Martin, Bill

AU - Roberts, Devender

AU - Mitchell, EA

AU - McCowan, LME

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N2 - Objective: To report maternal sleep practices in women who experienced a stillbirth compared with controls with ongoing live pregnancies at similar gestation.Design: Prospective case‐control study.Setting: Forty‐one maternity units in the United Kingdom.Population: Women who had a stillbirth after ≥ 28 weeks’ gestation (n = 291) and women with an ongoing pregnancy at the time of interview (n = 733).Methods: Data were collected using an interviewer‐administered questionnaire that included questions on maternal sleep practices before pregnancy, in the four weeks prior to, and on the night before the interview/stillbirth.Main outcome measures: Maternal sleep practices during pregnancy.Results: In multivariable analysis, supine going‐to‐sleep position the night before stillbirth had a 2.3‐fold increased risk of late stillbirth [adjusted Odds Ratio (aOR) 2.31, 95% CI 1.04–5.11] compared with the left side. In addition, women who had a stillbirth were more likely to report sleep duration less than 5.5 hours on the night before stillbirth (aOR 1.83, 95% CI 1.24–2.68), getting up to the toilet once or less (aOR 2.81, 95% CI 1.85–4.26), and a daytime nap every day (aOR 2.22, 95% CI 1.26–3.94). No interaction was detected between supine going‐to‐sleep position and a small‐for‐gestational‐age infant, maternal body mass index, or gestational age. The population‐attributable risk for supine going‐to‐sleep position was 3.7% (95% CI 0.5–9.2).Conclusions: This study confirms that supine going‐to‐sleep position is associated with late stillbirth. Further work is required to determine whether intervention(s) can decrease the frequency of supine going‐to‐sleep position and the incidence of late stillbirth.

AB - Objective: To report maternal sleep practices in women who experienced a stillbirth compared with controls with ongoing live pregnancies at similar gestation.Design: Prospective case‐control study.Setting: Forty‐one maternity units in the United Kingdom.Population: Women who had a stillbirth after ≥ 28 weeks’ gestation (n = 291) and women with an ongoing pregnancy at the time of interview (n = 733).Methods: Data were collected using an interviewer‐administered questionnaire that included questions on maternal sleep practices before pregnancy, in the four weeks prior to, and on the night before the interview/stillbirth.Main outcome measures: Maternal sleep practices during pregnancy.Results: In multivariable analysis, supine going‐to‐sleep position the night before stillbirth had a 2.3‐fold increased risk of late stillbirth [adjusted Odds Ratio (aOR) 2.31, 95% CI 1.04–5.11] compared with the left side. In addition, women who had a stillbirth were more likely to report sleep duration less than 5.5 hours on the night before stillbirth (aOR 1.83, 95% CI 1.24–2.68), getting up to the toilet once or less (aOR 2.81, 95% CI 1.85–4.26), and a daytime nap every day (aOR 2.22, 95% CI 1.26–3.94). No interaction was detected between supine going‐to‐sleep position and a small‐for‐gestational‐age infant, maternal body mass index, or gestational age. The population‐attributable risk for supine going‐to‐sleep position was 3.7% (95% CI 0.5–9.2).Conclusions: This study confirms that supine going‐to‐sleep position is associated with late stillbirth. Further work is required to determine whether intervention(s) can decrease the frequency of supine going‐to‐sleep position and the incidence of late stillbirth.

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