Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis

Warland, Jane; Dorrian, Jillian; Morrison, Janna L.; O'Brien, Louise M.

doi:10.1016/j.smrv.2018.03.004

Cited by 224Pregnancy and preeclampsia studiesSleep and related disordersMaternal Mental Health During Pregnancy and Postpartum

Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis

Warland, Jane, Dorrian, Jillian, Morrison, Janna L., O'Brien, Louise M.·2018·Sleep Medicine Reviews

DOI 10.1016/j.smrv.2018.03.004

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Abstract

There is a wealth of evidence to say that sleep impacts maternal health during pregnancy, however, little has been published on fetal health and maternal sleep. This scoping review summarises current literature on maternal sleep including sleep disordered breathing, sleep quality, sleep duration and supine sleep position, as these relate to fetal outcomes specifically birth weight, growth, preterm birth and stillbirth. An overall interpretation of the studies evaluated shows that events occurring during maternal sleep such as obstructive sleep apnea, sleep disruption and sleep position may have a negative effect on the fetus resulting in altered growth, gestational length and even death. These effects are biologically and physically plausible. In conclusion, there is limited and often conflicting information on maternal sleep and fetal outcomes. However, existing evidence suggests that this is an important area for future research. This area is ripe for investigation if there is to be reduction in the physical, emotional, and financial burden of poor fetal outcomes related to maternal sleep.

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A previous meta-analysis evaluated the association between sleep quality and duration with the risk of preterm birth, but there was significantly high heterogeneity among the included studies and no subgroup or sensitivity analysis to identify the sources of heterogeneity and test the robustness of the main findings.
“A previous meta-analysis evaluated the association between sleep quality and duration with the risk of preterm birth [15], but there was significantly high heterogeneity among the included studies and no subgroup or sensitivity analysis to identify the sources of heterogeneity and test the robustness of the main findings.”
From Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies (2020) · cites this paper as [15]

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Association between Maternal Symptoms of Sleep Disordered Breathing and Fetal Telomere Length
Salihu, H. M., King, L., Patel, P., Paothong, A., Pradhan, A., Louis, J. M., Naik, E., Marty, P. J., & Whiteman, V. E. (2015) · SLEEP · doi:10.5665/sleep.4570 · Cited by 44 · see citing works
Effect of psychosocial stress and physical activity on low birthweight: A cohort study
Abeysena, C., Jayawardana, P. L., & Seneviratne, R. D. A. (2010) · Journal of obstetrics and gynaecology research · doi:10.1111/j.1447-0756.2009.01155.x · Cited by 44 · see citing works
Self-reported sleep in late pregnancy in relation to birth size and fetal distress: the E Moe, Māmā prospective cohort study
Howe, L. D., Signal, T. L., Paine, S., Sweeney, B., Priston, M., Muller, D., Lee, K., Huthwaite, M., & Gander, P. H. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008910 · Cited by 44 · see citing works
Association Between Preterm Delivery and Pre-pregnancy Body Mass (BMI), Exercise and Sleep During Pregnancy Among Working Women in Southern California
Guendelman, S., Pearl, M., Kosa, J. L., Graham, S., Abrams, B., & Kharrazi, M. (2013) · Maternal and Child Health Journal · doi:10.1007/s10995-012-1052-5 · Cited by 43 · see citing works
Oxidative stress markers in pregnant women who snore and fetal outcome: a case control study
Köken, G., Şahin, F. K., Çoşar, E., Saylan, F., Yılmaz, N., Altuntaş, İ., Fidan, F., UNLU, M., & Yılmazer, M. (2007) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340701662183 · Cited by 40 · see citing works
Sleep-disordered breathing in pregnancy: a review of the physiology and potential role for positional therapy
Morong, S., Hermsen, B. B. J., & de Vries, N. (2013) · Sleep And Breathing · doi:10.1007/s11325-013-0849-9 · Cited by 38 · see citing works
Shorter sleep duration in early pregnancy is associated with birth length: a prospective cohort study in Wuhan, China
Wang, W., Zhong, C., Zhang, Y., Huang, L., Chen, X., Zhou, X., Chen, R., Li, X., Xiao, M., Hao, L., et al. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.03.013 · Cited by 38 · see citing works
Typical sleep positions in pregnant women
O'Brien, L. M., & Warland, J. (2014) · Early Human Development · doi:10.1016/j.earlhumdev.2014.03.001 · Cited by 37 · see citing works
Self-citation
Premature Labor and Birth: Influence of Rank and Perception of Fatigue in Active Duty Military Women
Stinson, J., & Lee, K. A. (2003) · Military Medicine · doi:10.1093/milmed/168.5.385 · Cited by 36 · see citing works
The Association Between Prenatal Sleep Quality and Obstetric Outcome
Hung, H., Ko, S., & Chen, C.-H. (2014) · Journal of Nursing Research · doi:10.1097/jnr.0000000000000039 · Cited by 35 · see citing works
Maternal snoring during pregnancy is not associated with fetal growth restriction
Tauman, R., Sivan, Y., Katsav, S., Greenfeld, M., & Many, A. (2011) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2011.629255 · Cited by 30 · see citing works
Risk of Respiratory Distress Syndrome and Efficacy of Glucocorticoids: Are They the Same in the Normally Grown and Growth-Restricted Infant?
McGillick, E. V., Orgeig, S., Williams, M., & Morrison, J. L. (2016) · Reproductive Sciences · doi:10.1177/1933719116660842 · Cited by 28 · see citing works
Self-citation
CrossTalk opposing view: Most cardiovascular diseases in sleep apnoea are not caused by sympathetic activation
Lavie, L., & Lavie, P. (2012) · The Journal of Physiology · doi:10.1113/jphysiol.2012.233833 · Cited by 27 · see citing works
Sleep disturbances in pregnant patients and the relation to obstetric outcome.
Uğur, M. G., Boynukalin, K., Atak, Z., Üstüner, İ., Atakan, R., & Baykal, C. M. (2012) · PubMed · Cited by 25 · see citing works
Triggers of Spontaneous Preterm Delivery – Why Today?
Hernández‐Díaz, S., Boeke, C. E., Romans, A. T., Young, B., Margulis, A. V., McElrath, T. F., Ecker, J. L., & Bateman, B. T. (2014) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12105 · Cited by 25 · see citing works
Obstructive sleep apnea and the risk of preterm delivery
Na-Rungsri, K., Lertmaharit, S., Lohsoonthorn, V., Totienchai, S., & Jaimchariyatam, N. (2016) · Sleep And Breathing · doi:10.1007/s11325-016-1339-7 · Cited by 23 · see citing works
Markers of Oxidative Stress in Pregnant Women with Sleep Disturbances
Rajendiran, S., Swetha Kumari, A., Nimesh, A., Soundararaghavan, S., Ananthanarayanan, P. H., & Dhiman, P. (2015) · Oman Medical Journal · doi:10.5001/omj.2015.53 · Cited by 22 · see citing works
Maternal Sleep Disordered Breathing and Neonatal Outcome.
Bassan, H., Uliel‐Sibony, S., Katsav, S., Farber, M., & Tauman, R. (2016) · PubMed · Cited by 22 · see citing works
Sleep-Disordered Breathing in Pregnancy
Edwards, N., & Sullivan, C. E. (2008) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2007.10.010 · Cited by 21 · see citing works
Risk factors for still birth: a hospital based case control study
Lakshmi, S. T., Thankam, U., Jagadhamma, P., Ushakumari, A., Chellamma, N., & Hariharan, S. V. (2017) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20170567 · Cited by 21 · see citing works
The Effect of Impaired Sleep on Preterm Labour
Dolatian, M., Mehraban, Z., & Sadeghniat, K. (2014) · West Indian Medical Journal · doi:10.7727/wimj.2012.305 · Cited by 20 · see citing works
Should pregnant women sleep on their left?
Chappell, L. C., & Smith, G. C. S. (2011) · BMJ · doi:10.1136/bmj.d3659 · Cited by 15 · see citing works
Maternal and neonatal morbidities associated with obstructive sleep apnea complicating pregnancy
Jones, S. F. (2011) · Yearbook of Pulmonary Disease · doi:10.1016/j.ypdi.2010.12.021 · Cited by 4 · see citing works

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Sorted by citations

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., Buxton, A. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001123 · Cited by 8,300 · see citing works
Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001052 · Cited by 5,987 · see citing works
Heart Disease and Stroke Statistics—2021 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Cheng, S., Delling, F. N., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000950 · Cited by 5,784 · see citing works
2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association
Martin, S. S., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Barone Gibbs, B., Beaton, A. Z., Boehme, A. K., et al. (2024) · Circulation · doi:10.1161/cir.0000000000001209 · Cited by 2,800 · see citing works
2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association
Martin, S. S., Aday, A. W., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Beaton, A., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001303 · Cited by 1,206 · see citing works
Brain mechanisms of insomnia: new perspectives on causes and consequences
Someren, E. J. W. V. (2020) · Physiological Reviews · doi:10.1152/physrev.00046.2019 · Cited by 558 · see citing works
Sex differences in obstructive sleep apnoea
Bonsignore, M. R., Saaresranta, T., & Riha, R. L. (2019) · European Respiratory Review · doi:10.1183/16000617.0030-2019 · Cited by 345 · see citing works
Sleep disturbances during pregnancy and adverse maternal and fetal outcomes: A systematic review and meta-analysis
Lu, Q., Zhang, X., Wang, Y., Li, J., Xu, Y., Song, X., Su, S., Zhu, X., Vitiello, M. V., Shi, J., et al. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101436 · Cited by 311 · see citing works
2026 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association
Palaniappan, L. P., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Currie, M. E., Earlie, R. S., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001412 · Cited by 312 · see citing works
Sleep duration and health outcomes: an umbrella review
Li, J. H., Cao, D., Huang, Y. C., Chen, Z., Wang, R., Dong, Q. G., Wei, Q., & Liu, L. (2021) · Sleep And Breathing · doi:10.1007/s11325-021-02458-1 · Cited by 209 · see citing works
“According to the recommendations from the expert panel of the NSF [1, 2], the reference sleep duration for infants is between 12 and 15 h, pre-school children between 10 and 13 h, and schoolaged children between 9 and 11 h.”
MethodInfluential
Sleep quality across pregnancy and postpartum: effects of parity and race
Christian, L. M., Carroll, J., Porter, K. M., & Hall, M. H. (2019) · Sleep Health · doi:10.1016/j.sleh.2019.03.005 · Cited by 111 · see citing works
A Review on the Vagus Nerve and Autonomic Nervous System During Fetal Development: Searching for Critical Windows
Cerritelli, F., Frasch, M. G., Antonelli, M. C., Viglione, C., Vecchi, S., Chiera, M., & Manzotti, A. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.721605 · Cited by 108 · see citing works
“It has been reported in these cases a correlation with deficit in fetal growth, adverse outcomes for labor and birth, and even preterm birth (Lee and Gay, 2004; Micheli et al., 2011; Zafarghandi et al., 2012; Warland et al., 2018).”
Background
Impact of Early Nutrition, Physical Activity and Sleep on the Fetal Programming of Disease in the Pregnancy: A Narrative Review
Moreno‐Fernández, J., Ochoa, J. J., López‐Frías, M., & Díaz‐Castro, J. (2020) · Nutrients · doi:10.3390/nu12123900 · Cited by 112 · see citing works
“Furthermore, in several studies it has been described that women with pre-eclampsia, a condition associated with maternal obesity, more frequently present respiratory disturbances, nocturnal hypoxia events and obstructive sleep apnea [129,130].”
Background
Sleep Pharmacotherapy for Common Sleep Disorders in Pregnancy and Lactation
Miller, M. A., Mehta, N. D., Bilodeau, C. C., & Bourjeily, G. R. (2019) · CHEST Journal · doi:10.1016/j.chest.2019.09.026 · Cited by 86 · see citing works
An Individual Participant Data Meta-analysis of Maternal Going-to-Sleep Position, Interactions with Fetal Vulnerability, and the Risk of Late Stillbirth
Cronin, R. S., Li, M., Thompson, J., Gordon, A., Raynes‐Greenow, C. H., Heazell, A. E. P., Stacey, T., Culling, V., Bowring, V., Anderson, N. H., et al. (2019) · EClinicalMedicine · doi:10.1016/j.eclinm.2019.03.014 · Cited by 85 · see citing works
“The increased odds associated with the supine position may also be related to sleep-disordered breathing [21,22], which is exacerbated in the supine position [23] and by obesity [21], with both factors previously being associated with an increased risk of stillbirth [21].”
BackgroundSelf-citation
Exploring and mitigating potential bias when genetic instrumental variables are associated with multiple non-exposure traits in Mendelian randomization
Yang, Q., Sanderson, E., Tilling, K., Borges, M. C., & Lawlor, D. A. (2019) · doi:10.1101/19009605 · Cited by 85 · see citing works
“It has been suggested that having insomnia and other forms of sleep disturbance may be associated with lower offspring birthweight though results are inconsistent [76, 77].”
Result
Association between maternal sleep duration and quality, and the risk of preterm birth: a systematic review and meta-analysis of observational studies
Wang, L., & Jin, F. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-2814-5 · Cited by 73 · see citing works
Maternal sleep during pregnancy and adverse pregnancy outcomes: A systematic review and meta‐analysis
Wang, R., Xu, M., Yang, W., Xie, G., Yang, L., Shang, L., Zhang, B., Guo, L., Yue, J., Zeng, L., et al. (2022) · Journal of Diabetes Investigation · doi:10.1111/jdi.13770 · Cited by 60 · see citing works
Associations between insomnia and pregnancy and perinatal outcomes: Evidence from mendelian randomization and multivariable regression analyses
Yang, Q., Borges, M. C., Sanderson, E. C. M., Magnus, M. C., Kilpi, F., Collings, P. J., Soares, A. G., West, J., Magnus, P. M., Wright, J., et al. (2022) · PLoS Medicine · doi:10.1371/journal.pmed.1004090 · Cited by 58 · see citing works
“Recent systematic reviews have only identified 1 cross-sectional study of the association of insomnia with stillbirth [6,42].”
Background
Pregnancy anxiety and preterm birth: The moderating role of sleep.
Tomfohr‐Madsen, L. M., Cameron, E. E., Schetter, C. D., Campbell, T. S., O’Beirne, M., Letourneau, N. L., & Giesbrecht, G. F. (2019) · Health Psychology · doi:10.1037/hea0000792 · Cited by 55 · see citing works
Effects of sleep modulation during pregnancy in the mother and offspring: Evidences from preclinical research
Pires, G. N., Benedetto, L., Cortese, R., Gozal, D., Gulia, K. K., Kumar, V. M., Tufik, S., & Andersen, M. L. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13135 · Cited by 56 · see citing works
Sleep Habits of Women With Infertility
Eisenberg, E., Legro, R. S., Diamond, M. P., Huang, H., O'Brien, L. M., Smith, Y. R., Coutifaris, C., Hansen, K. R., Santoro, N. F., & Heping Zhang, D. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab474 · Cited by 54 · see citing works
Self-citation
Pioglitazone alleviates maternal sleep deprivation-induced cognitive deficits in male rat offspring by enhancing microglia-mediated neurogenesis
Han, Y., Wang, J., Zhao, Q., Xie, X., Song, R., Xiao, Y., Kang, X., Zhang, L., Zhang, Y., Peng, C. Y., et al. (2020) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2020.02.002 · Cited by 53 · see citing works
eHealth interventions for treatment and prevention of depression, anxiety, and insomnia during pregnancy: systematic review and Meta-analysis
Silang, K. A., Sohal, P. R., Bright, K. S., Leason, J., Roos, L., Lebel, C., Giesbrecht, G. F., & Tomfohr-Madsen, L. M. (2022) · JMIR Mental Health · doi:10.2196/31116 · Cited by 50 · see citing works
“Similarly, poor sleep during pregnancy is a predictor of poor birth outcomes [9], such as shorter gestational age in addition to increased risk for developing postpartum depression [6].”
Background
Gestational intermittent hypoxia induces endothelial dysfunction, reduces perivascular adiponectin and causes epigenetic changes in adult male offspring
Badran, M., Yassin, B. A., Lin, D. T. S., Kobor, M. S., Ayas, N., & Laher, I. (2019) · The Journal of Physiology · doi:10.1113/jp277936 · Cited by 53 · see citing works
“Conflicting data may stem from limited literature using objective measures of OSA and birth weights, as well as inadequate control for confounding factors (Telerant et al. 2018; Warland et al. 2018).”
Relationship between antenatal sleep quality and depression in perinatal women: A comprehensive meta-analysis of observational studies
Fu, T., Wang, C., Jin, Y., Zeng, Q., & Ma, C. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.01.125 · Cited by 53 · see citing works
Prediction of stillbirth: an umbrella review of evaluation of prognostic variables
Townsend, R., Sileo, F. G., Allotey, J., Dodds, J. P., Heazell, A. E. P., Jørgensen, L. N., Kim, V. B., Magee, L. A., Mol, B. W., Sandall, J., et al. (2020) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.16510 · Cited by 46 · see citing works
Melatonin use during pregnancy and lactation: A scoping review of human studies
Vine, T., Brown, G. M., & Frey, B. N. (2021) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2021-2156 · Cited by 46 · see citing works
Maternal night-time eating and sleep duration in relation to length of gestation and preterm birth.
Loy, S., Cheung, Y., Cai, S., Colega, M. T., Godfrey, K., Chong, Y., Shek, L., Tan, K., Chong, M., Yap, F., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2019.08.018 · Cited by 34 · see citing works
Association of maternal sleep before and during pregnancy with preterm birth and early infant sleep and temperament
Nakahara, K., Michikawa, T., Morokuma, S., Ogawa, M., Kato, K., Sanefuji, M., Shibata, E., Tsuji, M., Shimono, M., Kawamoto, T., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-67852-3 · Cited by 44 · see citing works
A Review of Sleep Architecture and Sleep Changes During Pregnancy
Sweet, L. M., Arjyal, S., Kuller, J. A., & Dotters-Katz, S. K. (2020) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0000000000000770 · Cited by 46 · see citing works
“tive little data are driving current practice principles and a distinct amount of conflicting information.(10)”
Background
Common sleep disorders in pregnancy: a review
Kember, A. J., Elangainesan, P., Ferraro, Z. M., Jones, C. A., & Hobson, S. R. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1235252 · Cited by 43 · see citing works
“Their study identified significant associations between sleep disturbances during pregnancy and maternal-fetal complications, including preeclampsia, gestational hypertension (GH), gestational diabetes mellitus (GDM), cesarean section (CS), preterm birth (PTB), large-for-gestational-age (LGA), and stillbirth, but not…”
BackgroundResultInfluential
A Longitudinal Study of Physical Activity to Improve Sleep Quality During Pregnancy
Tan, L., Zou, J., Zhang, Y., Yang, Q., & Shi, H. (2020) · Nature and Science of Sleep · doi:10.2147/nss.s253213 · Cited by 38 · see citing works
Prenatal Hypoxia Affects Foetal Cardiovascular Regulatory Mechanisms in a Sex- and Circadian-Dependent Manner: A Review
Šutovská, H. M., Babarikova, K., Zeman, M., & Molčan, Ľ. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23052885 · Cited by 33 · see citing works
Sleep and circadian rhythms during pregnancy, social disadvantage, and alterations in brain development in neonates
Hoyniak, C. P., Whalen, D. J., Luby, J. L., Barch, D. M., Miller, J. P., Zhao, P., Triplett, R. L., Ju, Y. S., Smyser, C. D., Warner, B. B., et al. (2023) · Developmental Science · doi:10.1111/desc.13456 · Cited by 33 · see citing works
“An emerging literature has shown that sleep/wake disruptions during pregnancy affect birth outcomes (Facco et al., 2019; Reschke et al., 2018; Warland et al., 2018), but to our knowledge, our study is the first that has found an association between maternal daily rest-activity rhythms during…”
Background
Modifiable risk factors for stillbirth: a literature review
Sánchez, T. E., Meaney, S., & O’Donoghue, K. (2019) · Midwifery · doi:10.1016/j.midw.2019.102539 · Cited by 31 · see citing works
Associations between Maternal Sleep Quality Throughout Pregnancy and Newborn Birth Weight
Liu, H., Hong, L., Li, C., Chen, L., Zhang, C., Liu, Z., Wu, Y., & Huang, H. (2019) · Behavioral Sleep Medicine · doi:10.1080/15402002.2019.1702551 · Cited by 31 · see citing works
Associations of Sleep With Sedentary Behavior and Physical Activity Patterns Across Pregnancy Trimesters
Whitaker, K. M., Zhang, D., Kline, C. E., Catov, J. M., & Gibbs, B. B. (2021) · Women s Health Issues · doi:10.1016/j.whi.2021.02.003 · Cited by 31 · see citing works
Investigating causal relations between sleep duration and risks of adverse pregnancy and perinatal outcomes: linear and nonlinear Mendelian randomization analyses
Yang, Q., Magnus, M. C., Kilpi, F., Santorelli, G., Soares, A. G., West, J., Magnus, P. M., Wright, J., Håberg, S. E., Sanderson, E. C. M., et al. (2022) · BMC Medicine · doi:10.1186/s12916-022-02494-y · Cited by 29 · see citing works
“associations of both short and long duration with GD, short duration with pre-eclampsia and PTB, and long duration with stillbirth [7-12].”
Background
Systemic inflammation and sympathetic activation in gestational diabetes mellitus with obstructive sleep apnea
Serednytskyy, O., Alonso‐Fernández, A., Ribot, C., Herranz, A., Larrínaga, A. Á. R. D., Sánchez, A., Rodríguez, P., Gil, A. V., Pía, C., Marin, J. P. C., et al. (2022) · BMC Pulmonary Medicine · doi:10.1186/s12890-022-01888-1 · Cited by 27 · see citing works
“Some evidence suggests that OSA is associated with adverse pregnancy outcomes, such as gestational diabetes mellitus (GDM), preeclampsia, gestational hypertension, and with fetal related outcomes, preterm birth and neonatal low weight [4, 5].”
Background
Gender medicine and sleep disorders: from basic science to clinical research
Perger, E., Silvestri, R., Bonanni, E., Perri, M. C. D., Fernandes, M., Provini, F., Zoccoli, G., & Lombardi, C. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1392489 · Cited by 25 · see citing works
Efficacy of cognitive behavioural therapy for insomnia or sleep disturbance in pregnant women: A systematic review ad meta‐analysis
Zheng, X., Zhu, Z., Chen, J., He, J., Zhu, Y., Zhang, L., & Qu, F. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13808 · Cited by 25 · see citing works
“, 2015), preterm birth (Chang et al., 2010; Maxmen, 2017; Warland et al., 2018), lower birth weight (Kloss et al.”
Background
Modifying Maternal Sleep Position in Late Pregnancy Through Positional Therapy: A Feasibility Study
Warland, J., Dorrian, J., Kember, A. J., Phillips, C., Borazjani, A., Morrison, J. L., & O'Brien, L. M. (2018) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7280 · Cited by 25 · see citing works
“As sleep duration and quality are also important to avert poor pregnancy outcomes in late pregnancy, 42,43 we suggest that it may be better to use PT to reduce supine sleep time in late pregnancy rather than simply asking the woman herself to try to maintain or avoid certain sleep positions.”
Self-citation
Obstructive Sleep Apnea Is Associated With Altered Glycemic Patterns in Pregnant Women With Obesity
Farabi, S. S., Barbour, L. A., HEISS, K. P., Hirsch, N. M., DUNN, E. Z., & Hernandez, T. L. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2019-00159 · Cited by 24 · see citing works
Characteristics of sleep/wake problems and delivery outcomes among pregnant Japanese women without gestational complications
Umeno, S., Kato, C., Nagaura, Y., Kondo, H., & Eto, H. (2020) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-020-02868-1 · Cited by 24 · see citing works
Mild maternal sleep-disordered breathing during pregnancy and offspring growth and adiposity in the first 3 years of life
Brener, A., Lebenthal, Y., Levy, S., Dunietz, G. L., Sever, O., & Tauman, R. (2020) · Scientific Reports · doi:10.1038/s41598-020-70911-4 · Cited by 23 · see citing works
Maternal stress or sleep during pregnancy are not reflected on telomere length of newborns
Ämmälä, A., Vitikainen, E., Hovatta, I., Paavonen, E. J., Saarenpää‐Heikkilä, O., Kylliäinen, A., Pölkki, P., Porkka‐Heiskanen, T., & Paunio, T. (2020) · Scientific Reports · doi:10.1038/s41598-020-71000-2 · Cited by 22 · see citing works
Influence of Obstructive Sleep Apnea on Systemic Inflammation in Pregnancy
Alonso‐Fernández, A., Quetglas, C. R., Herranz, A., Larrínaga, A. Á. R. D., Barón, A. S., Rodríguez, P., Gómez, A. V. G., Martínez, C. P., Marin, J. P. C., Nicolau, M. B., et al. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.674997 · Cited by 23 · see citing works
“OSA is associated with adverse pregnancy outcomes such as gestational diabetes mellitus (GDM) (8–10), pre-eclampsia (8), gestational hypertension (11), and with fetal related outcomes (12, 13), preterm birth, and neonatal low weight (14).”
Background
Prenatal sleep health and risk of offspring ADHD symptomatology and associated phenotypes: a prospective analysis of timing and sex differences in the ECHO cohort
Lugo-Candelas, C. I., Hwei, T., Lee, S., Lucchini, M., Aizza, A. S., Kahn, L. G., Buß, C., O’Connor, T. G., Ghassabian, A., Padula, A. M., et al. (2023) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2023.100609 · Cited by 22 · see citing works
Neonatal irritable sleep-wake rhythm as a predictor of autism spectrum disorders
Miike, T., Toyoura, M., Tonooka, S., Konishi, Y., Oniki, K., Saruwatari, J., Tajima, S., Kinoshita, J., Nakai, A., & Kikuchi, K. (2020) · Neurobiology of Sleep and Circadian Rhythms · doi:10.1016/j.nbscr.2020.100053 · Cited by 22 · see citing works
Effect of Acupuncture on Pregnancy-Related Insomnia and Melatonin: A Single-Blinded, Randomized, Placebo-Controlled Trial
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Authors: Warland, J., Dorrian, J., Morrison, J. L., & O'Brien, L. M.
Affiliations: University of South Australia (AU)
University of Michigan (US)
Corresponding author: Warland, Jane
ORCID: Warland, Jane
Dorrian, Jillian
Morrison, Janna L.
O'Brien, Louise M.
Venue: Sleep Medicine Reviews
Publisher: Elsevier BV
Published: 2018-10
Volume: 41
Pages: 197-219
ISSN: 1087-0792 (ISSN-L)
DOI: 10.1016/j.smrv.2018.03.004
OpenAlex: W2795097012
Semantic Scholar: 37c6431fcc314572f6cb399195c326b5d9c73f7a
Cited by: 224
References: 102
Citations by year: 2026: 16 · 2025: 27 · 2024: 24 · 2023: 27 · 2022: 41 · 2021: 36 · 2020: 29 · 2019: 20 · 2018: 2
FWCI: 3.51
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Sleep Medicine Reviews (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
UniSA Research Outputs Repository (University of South Australia) (submittedVersion)
Funders: NHMRC Career Development Fellowship (APP1066916)
American Sleep Medicine Foundation (111-SR-15)
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
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: maternal sleep, pregnancy, fetal outcomes, obstructive sleep apnea, sleep-disordered breathing, sleep quality, sleep duration, supine sleeping, birth weight, fetal growth, preterm birth, stillbirth, gestation length
MeSH terms: Female, Fetus, Humans, Mothers, Pregnancy, Pregnancy Complications, Sleep, Sleep Apnea Syndromes, Supine Position, Premature Birth, Stillbirth

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Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis

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