Abstract
Objectives
This study aimed to examine the association between sleep behaviors and cardiovascular
health (CVH) during pregnancy and test whether high-sensitivity C-reactive protein
(hs-CRP) mediates this association.
Methods
The study included 4204 pregnant women from the Maternal and Infant Health cohort
study in Hefei (MIH-Hefei). Information on sleep (chronotype, sleep duration, snoring,
daytime sleepiness, and insomnia) was collected through a touch-screen structured
questionnaire at 16-23 weeks’ gestation. CVH (body mass index, blood pressure, total
cholesterol, glucose, and smoking) and hs-CRP were measured at 24-28 weeks’ gestation.
The role of hs-CRP in the association between sleep and CVH was explored in a mediation
analysis, while adjusting for multiple confounding factors.
Results
Poor sleep score was significantly associated with poor gestational CVH metrics, including
an RR of 0.872 (95% CI, 0.810, 0.938) for having all ideal (vs. any nonideal) CVH
metrics; hs-CRP level was significantly associated with poor gestational CVH metrics,
including an RR of 0.531 (95% CI, 0.432, 0.609) for having all ideal (vs. any nonideal)
CVH metrics. Sleep scores were positively correlated with hs-CRP level (β, 0.020, 95% CI, 0.006, 0.034). Mediation analysis revealed that the association between
sleep and CVH mediated by hs-CRP was 12.31% (indirect effect, −0.0095, 95% CI, −0.0167,
−0.0042).
Conclusions
Poor sleep during pregnancy, particularly late chronotype and snoring, may worsen
CVH by increasing systemic chronic inflammation.
Keywords
Abbreviations:
BMI (body mass index), CVH (cardiovascular health), HAPO (hyperglycemia and adverse pregnancy outcome), hs-CRP (high sensitivity C-reactive protein), EPDS (Edinburgh postnatal depression scale), ESS (Epworth sleepiness scale), GDM (gestational diabetes mellitus), OGTT (oral glucose tolerance test), TC (total cholesterol)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 21, 2023
Accepted:
January 21,
2023
Received in revised form:
December 30,
2022
Received:
September 11,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
