A Position Modification Device for the Prevention of Supine Sleep During Pregnancy: A Randomised Crossover Trial

IF 4.7 1区医学 Q1 OBSTETRICS & GYNECOLOGY

Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2024-09-16 DOI:10.1111/1471-0528.17952

Danielle L. Wilson, Carley Whenn, Maree Barnes, Susan P. Walker, Mark E. Howard

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Abstract

Objective

To assess the effectiveness and acceptability of a pillow-like position modification device to reduce supine sleep during late pregnancy, and to determine the impacts on the severity of sleep-disordered breathing (SDB) and foetal well-being.

Design

Randomised cross-over study.

Setting and Population

Individuals in the third trimester of pregnancy receiving antenatal care at a tertiary maternity hospital in Australia.

Methods

Participants used their own pillow for a control week and an intervention pillow for a week overnight, in randomised order. Sleep position and total sleep time for each night of both weeks were objectively monitored, with a sleep study and foetal heart rate monitoring performed on the last night of each week.

Main Outcome Measures

Primary outcome = percentage of sleep time in the supine position; secondary outcomes = apnoea–hypopnoea index, foetal heart rate decelerations and birthweight centile.

Results

Forty-one individuals were randomised with data collected on 35 participants over 469 nights. There was no difference in percentage of total sleep time in the supine position overnight between the control or intervention pillow week (13.0% [6.1, 25.5] vs. 16.0% [5.6, 27.2], p = 0.81 with a mean difference of 2.5% [95% CI] = −0.7, 5.6, p = 0.12), and no difference in the severity of SDB or foetal heart rate decelerations across weeks. However, increased supine sleep was significantly related to a higher apnoea–hypopnoea index (r_s = 0.37, p = 0.003), lower birthweight (r_s = −0.45, p = 0.007) and lower birthweight centile (r_s = −0.45, p = 0.006). The proportion of supine sleep each night of the week varied widely both within and across participants, despite awareness of side-sleeping recommendations.

Conclusions

We found no evidence to suggest that the adoption of a pillow designed to discourage supine sleep was effective in late pregnancy, with women spending an average of 1 h per night supine. Alternative devices should be investigated, incorporating lessons learnt from this study to inform trials of supine sleep minimisation in pregnancy.

Trial Registration

Clinical Trial: (Australia New Zealand Clinical Trials Registry): ACTRN12620000371998

Abstract Image

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预防孕期仰卧睡眠的体位调整装置：随机交叉试验

目的：评估一种类似枕头的体位调整装置在孕晚期减少仰卧睡眠的有效性和可接受性，并确定其对睡眠呼吸障碍（SDB）的严重程度和胎儿健康的影响。

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来源期刊

Bjog-An International Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

10.90

自引率

5.20%

发文量

345

审稿时长

3-6 weeks

期刊介绍： BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.