Association between maternal sleep practices and risk of late stillbirth: a case-control study

Tomasina Stacey, John MD Thompson, Ed A Mitchell, Alec J Ekeroma, Jane M Zuccollo, Lesley ME McCowan

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Objectives To determine whether snoring, sleep position, and other sleep practices in pregnant women are associated with risk of late stillbirth.

Design Prospective population based case-control study.

Setting Auckland, New Zealand

Participants Cases: 155 women with a singleton late stillbirth (≥28 weeks’ gestation) without congenital abnormality born between July 2006 and June 2009 and booked to deliver in Auckland. Controls: 310 women with single ongoing pregnancies and gestation matched to that at which the stillbirth occurred. Multivariable logistic regression adjusted for known confounding factors.

Main outcome measure Maternal snoring, daytime sleepiness (measured with the Epworth sleepiness scale), and sleep position at the time of going to sleep and on waking (left side, right side, back, and other).

Results The prevalence of late stillbirth in this study was 3.09/1000 births. No relation was found between snoring or daytime sleepiness and risk of late stillbirth. However, women who slept on their back or on their right side on the previous night (before stillbirth or interview) were more likely to experience a late stillbirth compared with women who slept on their left side (adjusted odds ratio for back sleeping 2.54 (95% CI 1.04 to 6.18), and for right side sleeping 1.74 (0.98 to 3.01)). The absolute risk of late stillbirth for women who went to sleep on their left was 1.96/1000 and was 3.93/1000 for women who did not go to sleep on their left. Women who got up to go to the toilet once or less on the last night were more likely to experience a late stillbirth compared with women who got up more frequently (adjusted odds ratio 2.28 (1.40 to 3.71)). Women who regularly slept during the day in the previous month were also more likely to experience a late stillbirth than those who did not (2.04 (1.26 to 3.27)).

Conclusions This is the first study to report maternal sleep related practices as risk factors for stillbirth, and these findings require urgent confirmation in further studies.
LanguageEnglish
Pagesd3403
JournalBMJ
Volume342
DOIs
Publication statusPublished - 14 Jun 2011
Externally publishedYes

Fingerprint

Stillbirth
Case-Control Studies
Sleep
Mothers
Snoring
Pregnancy
Odds Ratio
Pregnant Women
Logistic Models
Outcome Assessment (Health Care)
Parturition
Interviews

Cite this

Stacey, T., Thompson, J. MD., Mitchell, E. A., Ekeroma, A. J., Zuccollo, J. M., & McCowan, L. ME. (2011). Association between maternal sleep practices and risk of late stillbirth: a case-control study. BMJ, 342, d3403. https://doi.org/10.1136/bmj.d3403
Stacey, Tomasina ; Thompson, John MD ; Mitchell, Ed A ; Ekeroma, Alec J ; Zuccollo, Jane M ; McCowan, Lesley ME. / Association between maternal sleep practices and risk of late stillbirth : a case-control study. In: BMJ. 2011 ; Vol. 342. pp. d3403.
@article{033993ad191d48609e2225d88af46075,
title = "Association between maternal sleep practices and risk of late stillbirth: a case-control study",
abstract = "Objectives To determine whether snoring, sleep position, and other sleep practices in pregnant women are associated with risk of late stillbirth.Design Prospective population based case-control study.Setting Auckland, New ZealandParticipants Cases: 155 women with a singleton late stillbirth (≥28 weeks’ gestation) without congenital abnormality born between July 2006 and June 2009 and booked to deliver in Auckland. Controls: 310 women with single ongoing pregnancies and gestation matched to that at which the stillbirth occurred. Multivariable logistic regression adjusted for known confounding factors.Main outcome measure Maternal snoring, daytime sleepiness (measured with the Epworth sleepiness scale), and sleep position at the time of going to sleep and on waking (left side, right side, back, and other).Results The prevalence of late stillbirth in this study was 3.09/1000 births. No relation was found between snoring or daytime sleepiness and risk of late stillbirth. However, women who slept on their back or on their right side on the previous night (before stillbirth or interview) were more likely to experience a late stillbirth compared with women who slept on their left side (adjusted odds ratio for back sleeping 2.54 (95{\%} CI 1.04 to 6.18), and for right side sleeping 1.74 (0.98 to 3.01)). The absolute risk of late stillbirth for women who went to sleep on their left was 1.96/1000 and was 3.93/1000 for women who did not go to sleep on their left. Women who got up to go to the toilet once or less on the last night were more likely to experience a late stillbirth compared with women who got up more frequently (adjusted odds ratio 2.28 (1.40 to 3.71)). Women who regularly slept during the day in the previous month were also more likely to experience a late stillbirth than those who did not (2.04 (1.26 to 3.27)).Conclusions This is the first study to report maternal sleep related practices as risk factors for stillbirth, and these findings require urgent confirmation in further studies.",
author = "Tomasina Stacey and Thompson, {John MD} and Mitchell, {Ed A} and Ekeroma, {Alec J} and Zuccollo, {Jane M} and McCowan, {Lesley ME}",
year = "2011",
month = "6",
day = "14",
doi = "10.1136/bmj.d3403",
language = "English",
volume = "342",
pages = "d3403",
journal = "The BMJ",
issn = "0267-0623",
publisher = "British Medical Journal Publishing Group",

}

Stacey, T, Thompson, JMD, Mitchell, EA, Ekeroma, AJ, Zuccollo, JM & McCowan, LME 2011, 'Association between maternal sleep practices and risk of late stillbirth: a case-control study', BMJ, vol. 342, pp. d3403. https://doi.org/10.1136/bmj.d3403

Association between maternal sleep practices and risk of late stillbirth : a case-control study. / Stacey, Tomasina; Thompson, John MD; Mitchell, Ed A; Ekeroma, Alec J; Zuccollo, Jane M; McCowan, Lesley ME.

In: BMJ, Vol. 342, 14.06.2011, p. d3403.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between maternal sleep practices and risk of late stillbirth

T2 - The BMJ

AU - Stacey, Tomasina

AU - Thompson, John MD

AU - Mitchell, Ed A

AU - Ekeroma, Alec J

AU - Zuccollo, Jane M

AU - McCowan, Lesley ME

PY - 2011/6/14

Y1 - 2011/6/14

N2 - Objectives To determine whether snoring, sleep position, and other sleep practices in pregnant women are associated with risk of late stillbirth.Design Prospective population based case-control study.Setting Auckland, New ZealandParticipants Cases: 155 women with a singleton late stillbirth (≥28 weeks’ gestation) without congenital abnormality born between July 2006 and June 2009 and booked to deliver in Auckland. Controls: 310 women with single ongoing pregnancies and gestation matched to that at which the stillbirth occurred. Multivariable logistic regression adjusted for known confounding factors.Main outcome measure Maternal snoring, daytime sleepiness (measured with the Epworth sleepiness scale), and sleep position at the time of going to sleep and on waking (left side, right side, back, and other).Results The prevalence of late stillbirth in this study was 3.09/1000 births. No relation was found between snoring or daytime sleepiness and risk of late stillbirth. However, women who slept on their back or on their right side on the previous night (before stillbirth or interview) were more likely to experience a late stillbirth compared with women who slept on their left side (adjusted odds ratio for back sleeping 2.54 (95% CI 1.04 to 6.18), and for right side sleeping 1.74 (0.98 to 3.01)). The absolute risk of late stillbirth for women who went to sleep on their left was 1.96/1000 and was 3.93/1000 for women who did not go to sleep on their left. Women who got up to go to the toilet once or less on the last night were more likely to experience a late stillbirth compared with women who got up more frequently (adjusted odds ratio 2.28 (1.40 to 3.71)). Women who regularly slept during the day in the previous month were also more likely to experience a late stillbirth than those who did not (2.04 (1.26 to 3.27)).Conclusions This is the first study to report maternal sleep related practices as risk factors for stillbirth, and these findings require urgent confirmation in further studies.

AB - Objectives To determine whether snoring, sleep position, and other sleep practices in pregnant women are associated with risk of late stillbirth.Design Prospective population based case-control study.Setting Auckland, New ZealandParticipants Cases: 155 women with a singleton late stillbirth (≥28 weeks’ gestation) without congenital abnormality born between July 2006 and June 2009 and booked to deliver in Auckland. Controls: 310 women with single ongoing pregnancies and gestation matched to that at which the stillbirth occurred. Multivariable logistic regression adjusted for known confounding factors.Main outcome measure Maternal snoring, daytime sleepiness (measured with the Epworth sleepiness scale), and sleep position at the time of going to sleep and on waking (left side, right side, back, and other).Results The prevalence of late stillbirth in this study was 3.09/1000 births. No relation was found between snoring or daytime sleepiness and risk of late stillbirth. However, women who slept on their back or on their right side on the previous night (before stillbirth or interview) were more likely to experience a late stillbirth compared with women who slept on their left side (adjusted odds ratio for back sleeping 2.54 (95% CI 1.04 to 6.18), and for right side sleeping 1.74 (0.98 to 3.01)). The absolute risk of late stillbirth for women who went to sleep on their left was 1.96/1000 and was 3.93/1000 for women who did not go to sleep on their left. Women who got up to go to the toilet once or less on the last night were more likely to experience a late stillbirth compared with women who got up more frequently (adjusted odds ratio 2.28 (1.40 to 3.71)). Women who regularly slept during the day in the previous month were also more likely to experience a late stillbirth than those who did not (2.04 (1.26 to 3.27)).Conclusions This is the first study to report maternal sleep related practices as risk factors for stillbirth, and these findings require urgent confirmation in further studies.

U2 - 10.1136/bmj.d3403

DO - 10.1136/bmj.d3403

M3 - Article

VL - 342

SP - d3403

JO - The BMJ

JF - The BMJ

SN - 0267-0623

ER -

Stacey T, Thompson JMD, Mitchell EA, Ekeroma AJ, Zuccollo JM, McCowan LME. Association between maternal sleep practices and risk of late stillbirth: a case-control study. BMJ. 2011 Jun 14;342:d3403. https://doi.org/10.1136/bmj.d3403