Sleep Disturbances in Early Pregnancy and the Risk of Preeclampsia: Qazvin Maternal and Neonatal Metabolic Outcomes Study (QMNMS).

Objectives: The association between sleep disturbances and hypertension has been reported in numerous studies. However, prospective cohort data on the role of sleep disturbances in the development of preeclampsia remain limited.

Methods: This prospective cohort study was conducted on pregnant women with a in Iran. Sleep quality was assessed at the first prenatal visit (gestational age ≤14 weeks) using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Multivariate logistic regression was run to investigate the independent role of sleep abnormalities in the development of preeclampsia.

Results: The final analysis was performed on 576 participants, of whom 3.5% developed preeclampsia. In the univariate analysis, short sleep duration (< 6 hours) and prolonged sleep latency was associated with a 5.5-time and 3.5-times higher risk of developing preeclampsia (95% CI: 1.5-20.9, P=0.011, and 95% CI:1.2-10.1, P=0.019, respectively). Considering the total PSQI score, fairly bad or very bad sleep quality was a risk factor for developing preeclampsia, with a relative risk of 4.9 in the univariate analysis (95% CI: 1.4-17.8, P=0.014). In the fully adjusted model, short sleep duration and prolonged sleep latency were associated with 7.2 and 4.5 times higher risk of preeclampsia, respectivey (95% CI: 1.6-33.1, P=0.011 and 95% CI:1.4-14.6, P=0.012, respectively). In this model, pregnant women with fairly bad or very bad sleep quality had 5.9 times higher risk of preeclampsia development ( 95% CI: 1.5-22.8, P=0.011).

Conclusions: This cohort study demonstrated the role of short sleep duration and prolonged sleep latency as the main components of poor sleep quality in the development of preeclampsia.