Association of adverse pregnancy outcomes with self-reported measures of sleep duration and timing in women who are nulliparous

Francesca L. Facco, Corette B. Parker, Shannon Hunter, Kathryn J. Reid, Phyllis C. Zee, Robert M. Silver, David M. Haas, Judith H. Chung, Grace W. Pien, Chia Ling Nhan-Chang, Hyagriv N. Simhan, Samuel Parry, Ronald J. Wapner, George R. Saade, Brian M. Mercer, Caroline Torres, Jordan Knight, Uma M. Reddy, William A. Grobman

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Study Objectives: To examine the relationship of self-reported sleep during pregnancy with adverse pregnancy outcomes. A secondary objective was to describe the concordance between self-reported and objectively assessed sleep during pregnancy. Methods: In this prospective cohort, women completed a survey of sleep patterns at 6 to 13 weeks' gestation (visit 1) and again at 22 to 29 weeks' gestation (visit 3). Additionally, at 16 to 21 weeks (visit 2), a subgroup completed a week-long sleep diary coincident with an actigraphy recording. Weekly averages of self-reported sleep duration and sleep midpoint were calculated. A priori, sleep duration < 7 hours was defined as "short," and sleep midpoint after 5:00 am was defined as "late." The relationship of these sleep abnormalities with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) was determined. Results: Of the 10,038 women enrolled, sleep survey data were available for 7, 524 women at visit 1 and 7, 668 women at visit 3. A total of 752 women also provided ≥ 5 days of sleep diary data coincident with actigraphy at visit 2. We did not observe any consistent relationship between self-reported short sleep and HDP or GDM. There was an association between self-reported late sleep midpoint and GDM (visit 1 adjusted odds ratio 1.67, 95% confidence interval 1.17, 2.38; visit 2 adjusted odds ratio 1.73, 95% confidence interval 1.23, 2.43). At visit 2, 77.1% of participants had concordance between their diary and actigraphy for short sleep duration, whereas 94.3% were concordant for sleep midpoint. Conclusions: Self-reported sleep midpoint, which is more accurate than self-reported sleep duration, is associated with the risk of GDM.

Original languageEnglish (US)
Pages (from-to)2047-2056
Number of pages10
JournalJournal of Clinical Sleep Medicine
Issue number12
StatePublished - Dec 15 2018
Externally publishedYes


  • Gestational diabetes
  • Hypertension
  • Pregnancy
  • Sleep duration
  • Sleep midpoint

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Pulmonary and Respiratory Medicine


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