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Could excessive sleep during pregnancy be related to stillbirths?



It can be hard to sleep during pregnancy. A variety of problems can interrupt sleep, including frequent urination, back pain, abdominal pain and shortness of breath. In addition, disturbing sleep during pregnancy can be risky for the fetus and help stem growth. However, a recent study suggests that excessive undisturbed sleep can also be a problem.

If you sleep uninterruptedly for nine or more hours, this may be related to the risk of late stillbirth, ie the loss or death of a baby before or during delivery.

"There has been much public attention to sleep deprivation and its health effects, but not so much ̵

1; perhaps too much – sleep, especially when it comes to pregnancy," said Louise O'Brien , Researcher at the Neurological Center for Sleep Disorders and Obstetrics and Gynecology at the University of Michigan. "Women are often worried when they wake up several times during the night when they are pregnant, but this can be a protective measure in this case."

O'Brien and her colleagues analyzed online surveys of 153 women who had had a late stillbirth (on or after 28 weeks of pregnancy) the month before the questionnaire was answered and 480 women who had a third trimester pregnancy or who recently gave birth to a baby born alive during the same period. The results, recently published in the journal Birth, suggest a link between long, undisturbed sleep and stillbirth, independent of other risk factors.

About one percent of pregnancies, or about 24,000 a year, are affected in the United States. Many of them were inexplicable, according to Centers for Disease Control and Prevention.

O'Brien said that both the women with stillborn babies and the women with live born babies reported a similar proportion of long sleep before pregnancy was 10 percent in both groups.

But nearly 30 percent of stillbirths reported having long sleep during the last month of pregnancy, compared to only 16 percent of women born alive with babies.

"A similar proportion of women in the stillbirth and live birth groups had slept well before pregnancy, but during pregnancy the stillbirth group had a significant increase in the proportion of women who had long sleeves ep, it seems that it is important to change the change in sleep duration during pregnancy, "she said. "Being a lifelong late sleeper against a long-sleeper due to pregnancy could be the difference."

She said further research is needed, notably the study of autonomic nervous system behavior that regulates body function and the sleep hormone system in late pregnancy.

She noted that while sleeping, blood pressure reaches its lowest point, but rises when it wakes up, causing a brief, transient rise. These short-lived increases in blood pressure could prevent longer periods of high blood pressure associated with fetal growth problems, premature birth, and stillbirths.

"Speculation that may have a lesser waking mothers with stillbirths The result was fewer episodes of blood pressure increases that could have been detrimental to the fetus, is intriguing," said Shawn Youngstedt, a sleep scientist at Arizona State University and the Phoenix VA Health Care Systems, who was not involved in the study. "In general," submerging "blood pressure at night is considered healthy, but they have made a convincing argument that prolonged drop in blood pressure during sleep could be detrimental to the fetus. Interestingly, the higher prevalence of hypertension in the control women compared to the cases supports their argument. "

In addition," the cases had a significantly higher prevalence of diabetes, which may partially explain the results, "he said." The authors also address a good point that depression and anxiety that were not measured contributed to it

But Neomi Shah, Associate Professor of Medicine, Lung, Intensive Care, and Sleep Medicine at the Mount Sinai Icahn School of Medicine, who was also not involved in the research, noted his limitations, especially that he had one Link between long uninterrupted sleep and stillbirth suggests but does not identify it as a cause.

Also, the research invites participants to specifically remember behavior, a methodology that can be problematic, Shah said.

"Recalls cases sleep duration rather than controls may overestimate their sleep duration, indicating an association with stillbirth even though in reality it does not really exist, "says Shah. "The relationship between long sleep duration and stillbirth needs to be confirmed in a true experimental study design so we can target it as a potentially modifiable risk factor for stillbirths."

The study confirmed the potential for "recall bias." he noted, however, that "care was taken to minimize the memory distortion by limiting the study to women who gave birth to a stillborn child in the previous month when events could be recalled."

Abuse is one of the established risk factors for stillbirths. Maternal sleep practices are not well understood and are a new focus of research. O'Brien's study follows others who have studied the links between mother's sleep habits and the condition of the fetus, including studies suggesting an association between sleep disturbances and stillbirths , While the current study asked for maternal sleep, not enough women reported sleeping on their back for a meaningful analysis, the researchers said.

O'Brien agreed with the need for further studies, especially if they induce behavioral changes that could prevent stillbirth.

"Many risk factors for stillbirths can not be changed once the pregnancy has started," she said. "However, we should consider any intervention that may prevent poor results. Progress in reducing stillbirths in stillbirths has been slow, but stillbirths are an urgent global health problem that should be at the center of further research programs.

As sleep disorders can also cause problems, O'Brien warned against deliberately waking pregnant women at night until the scientists know more.

"Although extreme sleep has been associated with maternal and child health risks, getting up at night is not likely to be a concern," she said.


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