女性睡眠时长与围产期不良结局发生事件存关联
创作:Epi汪 审核:Epi汪 2022年09月23日
  • 纳入多项大型队列数据,利用孟德尔随机化理论,确定78个反映女性睡眠时长的工具变量;
  • 总体来说,女性睡眠时长与死胎、围产期抑郁、后代出生体重存在非线性关系;
  • 较短和较长的睡眠时间都增加了死胎和低出生体重的风险,较短的睡眠时间增加了围产期抑郁症风险;
  • 与睡眠时长在8-9h/天的人相比,睡眠时长在<5h/天和≥10h/天的女性发生各种不良妊娠结局的风险均增高;
  • 睡眠时长与围产期结局之间的非线性关联需要被关注。
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Epi汪
睡眠的时长与健康的关系备受关注。本研究借助于孟德尔随机化理论和工具变量,发现睡眠时长与围产期不良结局的非线性关系,提示我们过长或过短的睡眠可能都是有害的。本研究为孕期保健指导提供了基础。
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BMC Medicine [IF:11.15]

Investigating causal relations between sleep duration and risks of adverse pregnancy and perinatal outcomes: linear and nonlinear Mendelian randomization analyses

调查睡眠时间与不良妊娠风险和围产期结局之间的因果关系:线性和非线性孟德尔随机分析

10.1186/s12916-022-02494-y

2022-09-12, Article

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Background:: Observational studies have reported maternal short/long sleep duration to be associated with adverse pregnancy and perinatal outcomes. However, it remains unclear whether there are nonlinear causal effects. Our aim was to use Mendelian randomization (MR) and multivariable regression to examine nonlinear effects of sleep duration on stillbirth (MR only), miscarriage (MR only), gestational diabetes, hypertensive disorders of pregnancy, perinatal depression, preterm birth and low/high offspring birthweight.
Methods: : We used data from European women in UK Biobank (N=176,897), FinnGen (N=~123,579), Avon Longitudinal Study of Parents and Children (N=6826), Born in Bradford (N=2940) and Norwegian Mother, Father and Child Cohort Study (MoBa, N=14,584). We used 78 previously identified genetic variants as instruments for sleep duration and investigated its effects using two-sample, and one-sample nonlinear (UK Biobank only), MR. We compared MR findings with multivariable regression in MoBa (N=76,669), where maternal sleep duration was measured at 30 weeks.
Results:: In UK Biobank, MR provided evidence of nonlinear effects of sleep duration on stillbirth, perinatal depression and low offspring birthweight. Shorter and longer duration increased stillbirth and low offspring birthweight; shorter duration increased perinatal depression. For example, longer sleep duration was related to lower risk of low offspring birthweight (odds ratio 0.79 per 1 h/day (95% confidence interval: 0.67, 0.93)) in the shortest duration group and higher risk (odds ratio 1.40 (95% confidence interval: 1.06, 1.84)) in the longest duration group, suggesting shorter and longer duration increased the risk. These were supported by the lack of evidence of a linear effect of sleep duration on any outcome using two-sample MR. In multivariable regression, risks of all outcomes were higher in the women reporting <5 and ≥10 h/day sleep compared with the reference category of 8-9 h/day, despite some wide confidence intervals. Nonlinear models fitted the data better than linear models for most outcomes (likelihood ratio P-value=0.02 to 3.2×10-52), except for gestational diabetes.
Conclusions: : Our results show shorter and longer sleep duration potentially causing higher risks of stillbirth, perinatal depression and low offspring birthweight. Larger studies with more cases are needed to detect potential nonlinear effects on hypertensive disorders of pregnancy, preterm birth and high offspring birthweight.

First Authors:
Qian Yang

Correspondence Authors:
Qian Yang

All Authors:
Qian Yang,Maria C Magnus,Fanny Kilpi,Gillian Santorelli,Ana Gonçalves Soares,Jane West,Per Magnus,John Wright,Siri Eldevik Håberg,Eleanor Sanderson #,Deborah A Lawlor #,Kate Tilling #,Maria Carolina Borges #

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