The prevalence of placenta previa in pregnancies complicated by amniotic fluid embolism: 130

Abstract

Supplem Chicago Pritzker School of Medicine, Evanston, IL, Northwestern University Feinberg School of Medicine, Chicago, IL, University of Pittsburgh School of Medicine, Pittsburgh, PA, Yale School of Medicine, New Haven, CT, Charité, Universitätsmedizin Berlin, Berlin, Brandenburg, Germany, University of California Irvine, Irvine, CA OBJECTIVE: Elevated inflammatory markers are associated with alterations in fetal development and adverse birth outcomes. Adequate sleep may be important for regulating inflammatory processes during pregnancy. The purpose of this analysis was to evaluate associations between inflammatory markers and self-reported sleep duration in pregnant women. STUDY DESIGN: Of 744 pregnant women enrolled in a multi-site prospective cohort study, 694 completed a survey on sleep quality and provided a serum sample between 12-20 weeks gestation. Sleep quality was evaluated using the validated Pittsburgh Sleep Quality Index, which includes a question on average hours of sleep per night. Levels of inflammatory markers, including TNFa, CRP, IL6, and IL10, were measured in maternal serum and log transformed. A ratio of IL6:IL10 was calculated as an indicator of pro-inflammatory and anti-inflammatory balance. Multivariable linear regression was used to evaluate the associations between each of the inflammatory markers and selfreported hours of sleep per night. RESULTS: Women reported an average of 6.9 hours of sleep per night (standard deviation: 1.6). In models adjusted for maternal age, race/ethnicity, education, income, BMI, marital status, smoking, and gestational age at assessment, a one-hour decrease in average amount of sleep per night was associated with increases in log CRP and log IL6:IL10 ratio (CRP b: 0.024, 95% confidence interval [CI]: 0.003, 0.046; IL6:IL10 b: 0.039, 95% CI: 0.008, 0.070). The average amount of sleep per night was not associated with TNFa, IL6, or IL10 alone. CONCLUSION: Self-reported shorter sleep duration was associated with increases in CRP and IL6:IL10 ratio, even when controlling for key maternal demographics including BMI. Further studies should evaluate whether adequate sleep during pregnancy can help regulate inflammatory processes and improve outcomes.