lancet-header
Preprints with The Lancet is part of SSRN´s First Look, a place where journals and other research experts identify content of interest prior to publication. These preprint papers are not peer-reviewed and are posted here as part of a 12-month trial. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet, or submitted directly via SSRN. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed. For more information see the Comment published in The Lancet, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com

Maternal Sleep Position and Adverse Pregnancy Outcomes: The NuMoM2b Prospective Cohort Study

28 Pages Posted: 5 Mar 2019

See all articles by Robert M. Silver

Robert M. Silver

University of Utah - Department of Obstetrics and Gynecology

Shannon Hunter

RTI International

Uma M. Reddy

Yale University

Francesca Facco

University of Pittsburgh

Karen J. Gibbins

Oregon Health and Science University

William A. Grobman

Northwestern University

Brian M. Mercer

Case Western Reserve University

David M. Haas

Indiana University

Hyagriv N. Simhan

University of Pittsburgh

Samuel Parry

University of Pennsylvania

Ronald J. Wapner

Columbia University

Judette Louis

University of South Florida

Judith M. Chung

University of California, Irvine

Grace Pien

Johns Hopkins University

Frank P. Schubert

Indiana University

George R. Saade

University of Texas Medical Branch-Galveston

Phyllis Zee

Northwestern University

Susan Redline

Harvard University - Brigham and Women's Hospital

Corette B. Parker

RTI International

NuMoM2b study Group

More...

Abstract

Background: Maternal sleep position on the back or right side has been associated with adverse pregnancy outcomes, leading to recommendations to always sleep on the left side and maternal anxiety about sleep. However, available data are from case-control studies, which are subject to recall bias. Our objective was to examine the relationship between prospectively assessed sleep position and subsequent adverse pregnancy outcomes.

Methods: This was a secondary analysis of a prospective observational multicenter cohort study of nulliparous women with singleton gestations. Participants prospectively completed in-depth sleep questionnaires between 6+0 and 13+6 week's gestation (V1) and 22+0 and 29+6 week's gestation (V3). At each visit, women were asked in what position they went to sleep last night and on average during the past week. A subset of women also underwent level 3 home sleep tests using the Embletta Gold device. The primary outcome was a composite of adverse pregnancy outcomes including stillbirth, small for gestational age fetus (SGA), and gestational hypertensive disorders.

Results: 8,706 (of 10,038 total) women had data from at least one sleep questionnaire and for pregnancy outcomes, and they comprised the population for this analysis. There was no association between reported non-left lateral or supine sleep during the last week at V1 or V3 and the composite or any individual outcome, except for an apparent protective effect for stillbirth at V3. Women with objectively measured supine sleep position for > 50% of the time were no more likely than those in the supine position ≤ 50% of the time to have the composite adverse outcome.

Conclusions: Going to sleep in the supine or right lateral position, as self reported prior to the development of pregnancy outcome and objectively assessed through 30 weeks gestation was not associated with an increased risk of stillbirth, SGA fetus or gestational hypertensive disorders.

Trial Registration: clinicaltrials.gov (NCT01322529)

Funding Statement: This study is supported by grant funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): U10 HD063036, RTI International; U10 HD063072, Case Western Reserve University; U10 HD063047, Columbia University; U10 HD063037, Indiana University; U10 HD063041, University of Pittsburgh; U10 HD063020, Northwestern University; U10 HD063046, University of California Irvine; U10 HD063048, University of Pennsylvania; and U10 HD063053, University of Utah. In addition, support was provided by respective Clinical and Translational Science Institutes to Indiana University (UL1TR001108) and University of California Irvine (UL1TR000153).

Declaration of Interests: No conflicts of interest to declare or report.

Ethics Approval Statement: The study was approved by the Institutional Review Boards at each clinical site and the Data Coordinating Center, and all participants gave written informed consent.

Suggested Citation

Silver, Robert M. and Hunter, Shannon and Reddy, Uma M. and Facco, Francesca and Gibbins, Karen J. and Grobman, William A. and Mercer, Brian M. and Haas, David M. and Simhan, Hyagriv N. and Parry, Samuel and Wapner, Ronald J. and Louis, Judette and Chung, Judith M. and Pien, Grace and Schubert, Frank P. and Saade, George R. and Zee, Phyllis and Redline, Susan and Parker, Corette B. and Group, NuMoM2b study, Maternal Sleep Position and Adverse Pregnancy Outcomes: The NuMoM2b Prospective Cohort Study (02/25/2019 18:56:03). Available at SSRN: https://ssrn.com/abstract=3343654

Robert M. Silver (Contact Author)

University of Utah - Department of Obstetrics and Gynecology ( email )

30 North 1900 East
Room 2B308
Salt Lake City, UT 84132
United States

Shannon Hunter

RTI International

PO Box 12194
Washington, DC 20036-3209
United States

Uma M. Reddy

Yale University

New Haven, CT 06520
United States

Francesca Facco

University of Pittsburgh

135 N Bellefield Ave
Pittsburgh, PA 15260
United States

Karen J. Gibbins

Oregon Health and Science University

3181 S.W. Sam Jackson Park Rd.
Portland, OR 97239-3098
United States

William A. Grobman

Northwestern University

2001 Sheridan Road
Evanston, IL 60208
United States

Brian M. Mercer

Case Western Reserve University

10900 Euclid Ave.
Cleveland, OH 44106
United States

David M. Haas

Indiana University

107 S Indiana Ave
100 South Woodlawn
Bloomington, IN 47405
United States

Hyagriv N. Simhan

University of Pittsburgh

135 N Bellefield Ave
Pittsburgh, PA 15260
United States

Samuel Parry

University of Pennsylvania

Philadelphia, PA 19104
United States

Ronald J. Wapner

Columbia University

3022 Broadway
New York, NY 10027
United States

Judette Louis

University of South Florida

Tampa, FL 33620
United States

Judith M. Chung

University of California, Irvine

P.O. Box 19556
Science Library Serials
Irvine, CA 62697-3125
United States

Grace Pien

Johns Hopkins University

Baltimore, MD 20036-1984
United States

Frank P. Schubert

Indiana University

107 S Indiana Ave
100 South Woodlawn
Bloomington, IN 47405
United States

George R. Saade

University of Texas Medical Branch-Galveston

Galveston, TX 77555
United States

Phyllis Zee

Northwestern University

2001 Sheridan Road
Evanston, IL 60208
United States

Susan Redline

Harvard University - Brigham and Women's Hospital

75 Francis St.
Boston, MA 02115
United States

Corette B. Parker

RTI International

PO Box 12194
Washington, DC 20036-3209
United States

No contact information is available for NuMoM2b study Group

Click here to go to TheLancet.com

Paper statistics

Abstract Views
173
Downloads
29