Can Short Sleep Duration in Pregnancy Lead to Child Neurodevelopmental Delay?

Maternal short sleep duration during pregnancy is associated with an increased risk for neurodevelopmental delays in offspring, especially in boys, according to study results published in The Journal of Clinical Endocrinology & Metabolism.

Researchers conducted a prospective cohort study to confirm the link between sleep duration in pregnancy and neurodevelopmental delays in offspring, as well as the potential role of fetal glucose metabolism in this association.

Eligible participants were enrolled in the study from 3 hospitals in China, aged at least 18 years, conceived by natural methods, had singleton live births, and did not have a history of psychiatric disorders.

Demographic and other pregnancy-related information were collected in midpregnancy (24-28 gestational weeks). Sleep duration was assessed using the Pittsburgh Sleep Quality Index questionnaire in mid- and late pregnancy (32-36 gestational weeks). Cord metabolic markers, including C-peptide, were measured using an immunoassay.

The researchers extracted offspring data using assessments of social, gross and fine motor, and linguistic skills, as confirmed by a pediatric health care provider.

Of 7059 mother-child pairs included in the analysis, 497 (7%) had offspring neurodevelopmental delays. The majority of the offspring with neurodevelopmental delays were of the male sex (56.7%).

Mothers of offspring with vs without neurodevelopmental delays were older, had lower educational levels, and were more likely to deliver by cesarean section. Of note, offspring with vs without developmental delays had higher cord blood C-peptide levels.

After adjusting for confounding factors, short sleep duration in midpregnancy was associated with neurodevelopmental delays in offspring (hazard ratio [HR], 1.60; 95% CI, 1.10-2.30), with stratified analysis revealing the association only in boys (HR, 2.05; 95% CI, 1.29-3.25). Persistent short sleep duration was positively associated with neurodevelopmental delays in offspring (HR, 1.89; 95% CI, 1.24-2.86), with the association only observed in boys (HR, 2.16; 95% CI, 1.27-3.68).

The researchers noted a significant association between short sleep duration and cord blood C-peptide during pregnancy, with higher levels in mid- than late pregnancy. In addition, offspring with a greater risk for neurodevelopmental delays had higher C-peptide levels in the serum than cord blood.

Cord blood C-peptide may be a mediator in the association between short sleep duration in midpregnancy and neurodevelopmental delays in boys. The indirect effect was 0.14 (95% CI, 0.06-0.23) and the direct effect was 0.83 (95% CI, 0.32-1.34), which accounted for 11.05% overall.

Limitations of the analysis were its observational nature, which may have resulted in unmeasured confounding factors; data collected on sleep health were based on a self-reported questionnaire; and the low predictive capacity of neurodevelopmental testing between ages 6 and 36 months, especially for mild impairments.

“Optimizing the sleep mode may help mothers who experience [short sleep duration] during pregnancy avoid developmental delays in their offspring,” the researchers concluded.