Sleep quality and gestational diabetes in pregnant women: a systematic review and meta-analysis
Abstract
Poor sleep quality is very common among pregnant women. Gestational diabetes mellitus (GDM) has been related to various adverse maternal and neonatal outcomes. The aim of this systematic review was to examine the association between poor sleep quality and gestational diabetes risk. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted in five electronic databases from inception to February 2019. Studies that examined the relationship between sleep quality and glucose in pregnant women were screened for eligibility. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated from aggregate data using a fixed-effect model. Thirteen non-experimental studies (n = 21,194 women) were eligible for inclusion. Poor sleep quality was measured using subjective questionnaires in nine studies and objective methods (actigraphy or polysomnography) in four studies. GDM was typically diagnosed following standard guidelines. Eight studies were included in the meta-analysis for GDM. Overall, self-reported poor sleep quality was a significant risk factor for GDM (pooled OR = 1.43, 95%CI: 1.16,1.77, p = 0.001). Three studies examined the association between objective sleep quality and GDM, but no significant relationship was observed. Subjective poor sleep quality was related to an increased risk for GDM, while objectively measured sleep quality was not. This review was limited by the assessment of sleep quality. Future larger studies are warranted to examine the effects of sleep quality on glucose metabolism in pregnancy. Ideally, these studies should measure sleep quality using both validated questionnaires and objective methods. These will provide further directions for improving sleep during pregnancy and exploring its effects on glucose metabolism.
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Sleep disorders are possibly a risk factor for gestational diabetes mellitus.
“The associations between sleep problems and diabetes are complex: sleep disorders are a risk factor for developing type 2 diabetes (430,431) and possibly gestational diabetes mellitus (432,433).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [432]
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- Authors
- Zhu, B., Shi, C., Park, C. G., & Reutrakul, S.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Second Military Medical University (CN)
- University of Illinois Chicago (US)
- Corresponding author
- Zhu, Bingqian
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 67
- Pages
- 47-55
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W2991823155
- Cited by
- 45
- References
- 66
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 7 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 1
- FWCI
- 0.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- sleep quality, gestational diabetes mellitus, pregnancy, risk factors, glucose metabolism, subjective sleep quality, objective sleep measurement, actigraphy, polysomnography, maternal outcomes
- MeSH terms
- Female, Humans, Sleep Initiation and Maintenance Disorders, Pregnancy, Risk Factors, Sleep, Diabetes, Gestational, Polysomnography, Actigraphy
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