Antecedents and Consequences of Poor Prenatal Sleep Health

• In Event: Integrative and Translational Approaches to Sleep Health During the Perinatal Period

Abstract

Prenatal sleep health is a pervasive public health concern that may impact the health and well-being of pregnant individuals and their offspring (Mindell et al., 2015). For this reason, it is critical to understand both the causes and consequences of poor sleep health during this sensitive period of development. Antecedents of prenatal sleep health remain largely unknown, and it is plausible that childhood experiences exert an effect (Crandall et al., 2019). In turn, poor prenatal sleep has been linked to birth outcomes such as preterm birth, and low birth weight (Okun et al., 2011; Wang et al., 2017). However, the links between prenatal sleep health and newborn brain structure remain unknown. This presentation will present two studies addressing antecedents and consequences of prenatal sleep health.

Study 1. Method & Results: Study 1 examined the links between childhood experiences and prenatal sleep quality. Participants included 164 pregnant individuals (Mage=30.31, SDage=5.36). Adverse and benevolent childhood experiences were measured using the Adverse Childhood Experiences scale (ACEs; Felitti et al., 1998) and Benevolent Childhood Experiences scale (BCEs; Narayan et al., 2018) questionnaires. Sleep quality was measured at 17 (M=17.3, SD=4.6), 29 (M=28.6, SD=3.9), and 35 (M=35.3, SD = 1.7) gestational weeks using the Pittsburg Sleep Quality Index (PSQI; Buysee, 1989). Hierarchical linear modeling demonstrated that higher ACEs predicted poorer sleep quality (b = 0.36, SE = 0.13, p = .004), while higher BCEs predicted better sleep quality (b = − 0.60, SE = 0.17, p < .001). Associations persisted across pregnancy and remained when controlling for stressful life experiences during pregnancy, socioeconomic status, and obstetric complications.
Conclusion: These findings underscore the need for providers to assess not only adverse childhood experiences in healthcare settings, but also positive childhood experiences or they will otherwise miss an alternative promotive pathway contributing to prenatal sleep.
Study 2. Method & Results: Study 2 assesses the links between prenatal sleep quality and newborn brain structure. Participants included 94 pregnant individuals (Mage=30; SDage=5.29) and their newborns (53% female). Prenatal sleep quality was measured three times over pregnancy using the PSQI (Buysee, 1989). Newborn hippocampal and amygdala volumes were assessed during unsedated sleep using structural magnetic resonance imaging (MRI; M=44.22, SD=2.56, range=42-56 postconceptional weeks). Hierarchical linear modeling demonstrated that trajectories of prenatal sleep quality predicted bilateral hippocampal volume (all bs > 0.00004, all ps ≤ .01). Poor sleep quality early in pregnancy was associated with larger hippocampal volume bilaterally (all bs > 0.01, all ps ≤ .01). Prenatal sleep quality was not associated with amygdala volume.
Conclusion: These findings highlight the intergenerational implications of poor prenatal sleep quality and its role in contributing to newborn hippocampal development.
Together, this talk posits prenatal sleep health as a developmental process informed by childhood experiences that can also predict fetal brain structure.

Authors

• Melissa Nevarez-Brewster, University of Denver
  Presenting Author

• Özlü Aran, University of Denver

• Angela J. Narayan, University of Denver

• Kylie Harrall

• Samantha Brown, Colorado State University

• Catherine Demers, University of Denver

• Alexandra Mejia

• Mercedes Hoeflich Haase, University of North Carolina at Chapel Hill

• Maria M Bagonis, University of North Carolina at Chapel Hill

• Sun Hyung Kim, University of North Carolina

• John H. Gilmore, University of North Carolina at Chapel Hill

• Camille Hoffman, University of Colorado Anschutz Medical Campus

• Martin Styner, University of North Carolina at Chapel Hill

• Benjamin Hankin, University of Illinois at Urbana-Champaign

• Elysia Poggi Davis, University of Denver