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Antenatal sleep quality associated with perinatal outcomes in women of advanced maternal age

  • Pei Yu Lee
    Affiliations
    Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore 119228
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  • Li Hui Liu
    Affiliations
    Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore 119228
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  • Cowan Ho
    Affiliations
    Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore 119228
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  • Aloysius Jian Feng Ang
    Affiliations
    Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore 119228
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  • Hui Xin Huang
    Affiliations
    Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore 119228
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  • Oon-Hoe Teoh
    Affiliations
    Department of Paediatrics, KK Women’s and Children’s Hospital, 100 Bukit Timah Rd, Singapore 229899
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  • Kok-Hian Tan
    Affiliations
    Duke-NUS Medical School, 8 College Rd, Singapore 169857

    Division of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, 100 Bukit Timah Rd, Singapore 229899
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  • Yung Seng Lee
    Affiliations
    Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609

    Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Rd, Singapore 119228

    Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, 1E Kent Ridge Rd, Singapore 119228
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  • Fabian Yap
    Affiliations
    Department of Paediatric Endocrinology, KK Women’s and Children’s Hospital, 100 Bukit Timah Rd, Singapore 229899
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  • Joshua J. Gooley
    Affiliations
    Program in Neuroscience and Behavioural Disorders, Duke-NUS Medical School, 8 College Rd, Singapore 169857

    Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Rd, Singapore 119228
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  • Shiao-Yng Chan
    Affiliations
    Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609

    Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Rd, Singapore 119228
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  • Shirong Cai
    Correspondence
    Corresponding author at: Brenner Center for Molecular Medicine, 30 Medical Drive, Singapore 117609. Tel: (+65) 66011948; Fax: (+65) 6782 6597.
    Affiliations
    Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, Singapore 117609

    Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 1E Kent Ridge Rd, Singapore 119228
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Published:December 19, 2019DOI:https://doi.org/10.1016/j.sleh.2019.10.009

      Abstract

      Objectives

      The increasing prevalence of advanced maternal age (AMA) coupled with poor sleep quality among pregnant women makes it important to study their association with perinatal outcomes. However, little is known about the interaction of AMA and maternal antenatal sleep on perinatal outcomes. Here, we examined whether associations between AMA and perinatal outcomes are modified by antenatal sleep quality.

      Participants

      Data were collected from 446 women, with a singleton pregnancy and no pregnancy complications, who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study.

      Measurements

      Participants completed the Pittsburgh Sleep Quality Index (PSQI) at 26-28 weeks gestation and had perinatal outcome data collected upon delivery. Interactions between AMA and maternal sleep quality on perinatal outcomes were investigated and where significant, analyses were further stratified by maternal age. All analyses were adjusted for maternal BMI at 26-28 weeks gestation, ethnicity, and maternal education.

      Results

      Neonates of mothers of AMA and poor sleep quality (PSQI score >5) had increased odds of stay in the neonatal intensive care unit (adjusted odds ratio = 3.53, 95% CI: −1.21 to 10.27) and shorter birth length (adjusted mean difference = −1.05 cm, 95% CI: −1.82 to −0.20), as compared with women of AMA and good sleep quality (PSQI score ≤5). In women <35 years, sleep quality did not associate with perinatal outcomes.

      Conclusion

      Poor sleep quality in women of AMA was associated with neonatal health outcomes. Improving maternal antenatal sleep may potentially improve perinatal outcomes in offspring of women of AMA.

      Keywords

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