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

Importance Short 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. Objective To investigate whether persistently short sleep during pregnancy and after delivery is associated with incident hypertension and metabolic syndrome. Design, Setting, and Participants This 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. Exposures Self-reported short sleep duration (&amp;amp;lt;7 hours) during pregnancy and 2 to 7 years after delivery was defined as persistent short sleep. Main Outcomes and Measures Incident 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. Results Among 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 Relevance In 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.