Persistent Short Sleep Duration From Pregnancy to 2 to 7 Years After Delivery and Metabolic Health
Authors: Kim Minjee , Wiener Laura Elizabeth , Gilbert Jace , McNeil Rebecca B. , Reid Kathryn J. , Grobman William A. , Facco Francesca , Haas David M. , Silver Robert M. , Greenland Philip , Yee Lynn M. , Zee Phyllis C. ,   Eunice Kennedy Shriver National Institute of Child Health and Human Development NuMoM2b and National Heart, Lung, and Blood Institute NuMoM2b Heart Health Study Network, Dalton Wendy , Louis Judette M. , Mercer Brian M. , Polito LuAnn , Iams Jay , Latimer Cheryl , Basner Robert C. , DiVito Michelle , Fuchs Karin , Nhan-Chang Chia-Ling , Onativia Ameneh , Torres Caroline , Wapner Ronald , Hoffman Matthew K. , Lynch Stephanie , Davis Maurice , Reddy Uma M. , Willinger Marian , Mobley Daniel , Redline Susan , Surovec Susan , Ulanski Julianne , Barnes Shannon , Foroud Tatiana , McCormick Catherine L. , Perkins Emily , Schubert Frank P. , Winters Alicia , Laposky Aaron , Campbell Peggy , Peaceman Alan M. , Shepard Jessica S. , Williams Crystal N. , Alexander Barbara V. , DeCain Martha J. , Franklin Holly L. , Griggs Christopher , Holder Tommy E. , Hunter Shannon , Koch Matthew A. , McFadden Deborah W. , Parker Corette B. , Yetukuri Venkat , Chung Judith H. , Nageotte Michael P. , Pham Valerie , Porto Manuel , Rumney Pamela J. , Wadhwa Pathik D. , Wing Deborah A. , Araujo Brittany , Elovitz Michal , Ludmir Jack , Parry Samuel , Peters Mary , Pien Grace , Bickus Melissa , Caritis Steve N. , Daftary Ashi R. , Emery Stephen P. , Facco Francesca L. , Simhan Hyagriv N. , Speer Paul D. , Saade George R. , Christensen Kelly , Esplin M. Sean , Meadows Linda , Morby Valerie , Postma Julie , Williams Melanie , Aneja Ashish , Gibson Kelly , Pippen Jessica , Rosolowski Bonnie , Thomas Laniece , Bairey Merz C. Noel , Bello Natalie , Brower Ian , Marroquin Maria , Maughan Jenna , Sela Nathan , Wanke Brandon , Yu Eileen , Almonte Casandra , Ananth Cande , Barcelona Veronica , Booker Whitney , Chiu Jeremy , Cleary Kirsten , De La Cruz Nathalie , Firman Brandy , Gutierrez Yessenia , Haghighi Noora , Haro Carla , Haythe Jennifer , Korem Tal , Miller Eliza , Peguero Belgica , Reddy Uma , Rosado Feliz Jeimy , Yan Qi , Kitto Carrie , Nava Jennifer , Staples Amy , Kawakita Tetsuya , Spong Cathy , Honigberg Michael , Maro Erica-Jane , Roby-Fout Jessica , Scifres Christina , Shockley Hannah , Vasquez-Hout Ligia , Whipps Haley , Yeley Brittany , Minhas Anum , Pemberton Victoria L. , Twery Michael , Varagic Jasmina , Kershaw Kiarri , Khan Sadiya , Rangel Elizabeth , Jancsura McKenzie , Lynch Courtney , Venkatesh Kartik , Wu Jiqiang , Bann Carla , Carper Benjamin , Crenshaw Emma , Erman Brian , Fain Katie , Fisher Carl , Gilbert Jace , Gizlice Selen , Hanlon Sean , Harris Mallory , Hoellerich Joey , Kesler Karen , Kinsey Nick , Leblond David , Marsh Derek , McMillan Taya , Meier Heather , Moore Janet , Nielson Eleanor , Riggs Callie , Rhodes Evan , Sattaluri Sridevi , Thomas Emily W. , Thorsten Vanessa , Vandergrift Nathan , Williams Roger , Chen Yii-Der (Ida) , Huỳnh Phuong Linh L. , Kim Jin Kyung , Shahrokni Nikka , Spiers Lizette , Thornton Amanda , Zavala Jesi , Lane Abbi , Huang Caroline , Kozai Andrea , Levine Lisa , Lewey Jennifer , McCabe Meaghan , Monterroso Maria , Ngom Nadia , Simonette Keri , Subburaj Saisahana , Sy Fatoumata , Bodnar Lisa , Bryan Samantha , Catov Janet , Ekekwe Christiana , Evans Abigail , Hauspurg Alisse , Heinsberg Lacey , Huber Kimberly , Levine Michele , Lopata Victoria , Price Christofer , Ray Mitali , Tarr Jill , Whiteleather Julia , Blue Nathan , Cook Maggie , Heil Danielle , Metz Torri , Oliver Josh , Patterson Dexter , Schliep Karen , Theilen Lauren , Aldous Sharla , Breeze Stacey , Carlson Lindsey , Dellerman Sandi , Evans Holly , Hobbs Bri , Johnson Jessica , Krong Jake , Magana Diana , Meadows Catherine , Moore Rachel , Nunley Michael , Orton Kristin , Pederson Midra , St Hilaire Sara , Tingey Kailey , Unsworth Nic , Barone Gibbs Bethany 
Published: December 2024

ImportanceShort sleep duration during pregnancy and the perimenopausal period has been associated with adverse cardiometabolic outcomes. However, it remains unclear how sleep duration changes after delivery and whether such changes are associated with the cardiometabolic health of birthing people.ObjectiveTo investigate whether persistently short sleep during pregnancy and after delivery is associated with incident hypertension and metabolic syndrome.Design, Setting, and ParticipantsThis secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be Heart Health Study (NuMoM2b-HHS), an ongoing prospective cohort study, was conducted between September 5, 2023, and March 1, 2024, in 8 US academic medical centers. Participants were aged 18 years or older at NuMoM2b enrollment; recruited during their first pregnancy between October 1, 2010, and September 30, 2013; and followed up for a mean (SD) of 3.1 (0.9) years after delivery.ExposuresSelf-reported short sleep duration (&amp;lt;7 hours) during pregnancy and 2 to 7 years after delivery was defined as persistent short sleep.Main Outcomes and MeasuresIncident hypertension and metabolic syndrome (MetS) at follow-up. Regression models were used to estimate relative risks of incident hypertension and MetS by sleep duration pattern. Hypertension analyses excluded participants with hypertension at baseline, and MetS analyses excluded participants with MetS at baseline. Multivariable models included a priori covariates of baseline age and time from delivery to follow-up. Incident hypertension analyses included an additional covariate of body mass index at baseline.ResultsAmong 3922 participants (mean [SD] age, 27.3 [5.4] years; 598 Hispanic [15.2%], 485 non-Hispanic Black [12.4%], and 2542 non-Hispanic White [64.8%]), 565 individuals (14.4%) experienced persistent short sleep. Non-Hispanic Black (adjusted odds ratio [aOR], 2.17; 95% CI, 1.59-2.97) and unmarried (aOR, 1.68, 95% CI, 1.29-2.19) participants were significantly more likely to experience persistent short sleep compared with non-Hispanic White and married participants, respectively. Persistent short sleep was associated with higher odds of incident MetS (aOR, 1.60; 95% CI, 1.21-2.11) but not incident hypertension (aOR, 0.91; 95% CI, 0.69-1.19).Conclusions and RelevanceIn this study, short sleep duration that persisted from pregnancy to 2 to 7 years after delivery was associated with a greater risk for adverse cardiometabolic outcomes. Future studies should explore whether sleep-targeted interventions during and after pregnancy are associated with improved cardiometabolic health outcomes, particularly among populations at increased risk.