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Poster #38 - A pilot study of prenatal maternal sleep health, inflammation and pregnancy and, offspring birth outcomes

Thu, March 23, 4:15 to 5:00pm, Salt Palace Convention Center, Floor: 1, Hall A-B

Abstract

Background: Poor prenatal maternal sleep health has been associated with adverse pregnancy and offspring birth outcomes, including low birth weight and preterm birth (Liu et al., 2019; Wang et al., 2022). However, no studies have investigated inflammation as a possible mechanism for this relationship, and most prenatal sleep studies have not included minoritized racial and ethnic groups, which have been found to be at higher risk for sleep problems. Therefore, the present study aimed to explore the relationship between poor prenatal sleep health with prenatal inflammation and pregnancy, and offspring birth outcomes among a sample of Puerto Rican mother-infant dyads.
Methods: We explored the relationship between prenatal maternal sleep health, prenatal inflammation, and pregnancy/offspring birth outcomes within 265 Puerto Rican mother-infant dyads enrolled in the Boricua Youth Study Environmental influences on Child Health Outcomes (BYS-ECHO). Pregnant women had a mean age of 26.5 years (sd = 3.53 years) and lived in New York (n = 152) and Puerto Rico (n = 113). Women reported on their sleep health via the Sleep Quality Index questionnaire (indexing total sleep duration, disturbances, and overall quality). Saliva proinflammatory markers - C-reactive protein (CRP) and interleukin (IL-6) – were examined in a subsample of participants (n=47). Analyses controlled for maternal age, BMI, and prenatal depression symptoms and substance use. In line with prior prenatal programing research, offspring sex effects were examined by conducting analyses separately for male and female offspring.
Results: Pregnant women who reported poorer sleep quality had significantly higher rates of children birth prematurely (p=.012), but this relationship was no longer significant in adjusted models. We found no associations to offspring birth weight, and analyses examining potential sex effects were not significant. Preliminary analyses documented prenatal sleep quality was associated to IL-6 (p = 0.044), but not when adjusting for covariates. Sleep duration (p =.015) and disturbance (p =.088), although marginally, predicted CRP levels in unadjusted models. We did not document significant associations between inflammation and pregnancy complications or gestational age at birth. Due to reduced sample size, we could not explore the relationship between prenatal inflammation and offspring weight, nor sex effects.
Discussion: Our pilot study documents, within a sample of Puerto Rican dyads, preliminary associations between maternal poor sleep health - including perceptions of sleep disturbances, duration, and quality - with inflammation during pregnancy. Inflammation during pregnancy has been associated to a number of negative neurodevelopmental outcomes, including attention deficit hyperactivity disorder and autism spectrum disorder (Vizzini et al., 2019). Latinx individuals are more vulnerable for sleep disruptions, especially during pregnancy, suggesting that minoritized racial and ethnic groups could be particularly vulnerable to prenatal sleep-related health sequelae. However, we found limited evidence of the association between prenatal sleep health and inflammation markers with pregnancy and offspring birth outcomes, and no evidence of offspring sex differences, in our adjusted models. These findings suggest other prenatal factors (such as BMI) could have an equally significant impact on immediate pregnancy and birth outcomes. Larger studies are needed to dissociate these exposures, as well as longitudinal studies that examine associations to neurodevelopmental outcomes later in development.

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