Association of maternal sleep practices with pre-eclampsia, low birth weight, and stillbirth among Ghanaian women

Objective: To assess sleep practices, and investigate their relationship with maternal and fetal outcomes, among pregnant Ghanaian women. Methods: In a cross-sectional study conducted at Korle Bu Teaching Hospital, Accra, Ghana, between June and July 2011, postpartum women were interviewed within 48 hours of delivery about sleep quality and practices during pregnancy. Interviews were coupled with a systematic review of participants' medical charts for key outcomes including maternal hypertension, pre-eclampsia, premature delivery, low birth weight, and stillbirth. Results: Most women reported poor sleep quality during pregnancy. Snoring during pregnancy was independently associated with pre-eclampsia (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.4-8.5; P=0.007). The newborns of women who reported supine sleep during pregnancy were at increased risk of low birth weight (OR, 5.0; 95% CI, 12-20.2; P=0.025) and stillbirth (OR, 8.0; 95% CI, 1.5-43.2; P=0.016). Low birth weight was found to mediate the relationship between supine sleep and stillbirth. Conclusion: The present findings in an African population demonstrate that maternal sleep, a modifiable risk factor, has a significant role in pre-eclampsia, low birth weight, and subsequently stillbirth. (C) 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.