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

作者：Heazell A. E. P.; Li M.; Budd J.; Thompson J. M. D.; Stacey T.; Cronin R. S.; Martin B.; Roberts D.; Mitchell E. A.; McCowan L. M. E.

来源：BJOG: An International Journal of Obstetrics and Gynaecology , 2018, 125(2): 254-262.

DOI：10.1111/1471-0528.14967

• maternal sleep position
• modifiable risk factors
• sleep duration
• stillbirth

ObjectiveTo report maternal sleep practices in women who experienced a stillbirth compared with controls with ongoing live pregnancies at similar gestation.
DesignProspective case-control study.
SettingForty-one maternity units in the United Kingdom.
PopulationWomen who had a stillbirth after 28weeks' gestation (n=291) and women with an ongoing pregnancy at the time of interview (n=733).
MethodsData 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 measuresMaternal sleep practices during pregnancy.
ResultsIn 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 5.5hours 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).
ConclusionsThis 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.

• 出版日期2018-1