Felder JM, et al. – Analysts tested the hypothesis that sleep disorder diagnosis would be related to increased risk of preterm birth and examined the risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). It was concluded that insomnia and sleep apnea were related to significantly increased the risk of preterm birth. Considering the high prevalence of sleep disorders amid pregnancy and availability of evidence–based nonpharmacologic interventions, current outcomes propose that screening for severe presentations would be prudent.

Methods

• An observational study was performed for this research.
• In this study, participants were selected from a cohort of nearly 3 million women in California between 2007 and 2012.
• Inclusion criteria were women with singleton neonates live born between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness amid pregnancy.
• Sleep disorder was characterized based on International Classification of Diseases, 9th Revision, Clinical Modification diagnostic code (n=2,265).
• Propensity score matching was utilized to select a referent population at a one–to–one ratio.
• Odds of preterm birth were investigated by gestational age (less than 34 weeks, 34–36 weeks, and less than 37 weeks of gestation) and type (spontaneous, indicated).

Results

• They found the prevalence of preterm birth (before 37 weeks of gestation) was 10.9% in the referent group compared with 14.6% among women with a recorded sleep disorder diagnosis.
• Compared with the referent group, odds (95% CI, P value, percentage) of preterm birth were 1.3 (1.0–1.7, P=.023, 14.1%) for insomnia and 1.5 (1.2–1.8, P<.001, 15.5%) for sleep apnea.
• In this study, risk varied by gestational age and preterm birth type.
• They found that odds of preterm birth were not majorly increased for sleep–associated movement disorders or other sleep disorders.