Association of Maternal Short Sleep Duration With Neurodevelopmental Delay in Offspring: A Prospective Cohort Study

母亲睡眠时间短与后代神经发育迟缓的关系：一项前瞻性队列研究

Authors: Lei Zhang, Hai-Xia Wang, Wen-Xiang Li , Yuan-Yuan Zhu, Rui-Rui Ma, Yu-Hong Wang, Yu Zhang, Dao-Min Zhu, Peng Zhu.

Source: J Clin Endocrinol Metab. 2024 Sep 26:dgae569.

doi: 10.1210/clinem/dgae569.

Abstract

Context: To investigate how short sleep duration (SSD) during pregnancy is related to neurodevelopmental delays in offspring, we aimed to inform pregnancy sleep guidelines and promote maternal health and child development.

Objective: To identify the associations between SSD during pregnancy and offspring neurodevelopmental delay and to determine whether fetal glucose metabolism plays a role in SSD and neurodevelopmental delays.

Methods: This cohort study followed 7059 mother-child pairs from the Maternal & Infants Health in Hefei cohort, and collected sleep data during pregnancy via the Pittsburgh Sleep Quality Index at weeks 24 to 28 and 32 to 36. Neurodevelopmental outcomes from 6 to 36 months postpartum were assessed via the Denver Developmental Screening Test-II and the Gesell Development Diagnosis Scale. Cox proportional hazard regression was used to analyze the link between maternal SSD and neurodevelopmental delay risk. Mediation analysis was used to evaluate the role of cord blood serum C-peptide levels. Three hospitals and children's health centers in Hefei were involved.

Results: The stratified analysis revealed a significant association between mothers with SSD during midpregnancy and neurodevelopmental delay in boys (adjusted HR 2.05, 95% CI 1.29, 3.25). Cord blood marker analysis revealed a positive relationship between cord blood serum C-peptide levels and neurodevelopmental delay in offspring (RR 0.04, 95% CI 0.00, 0.08). The proportion of the association between SSD and neurodevelopmental delay mediated by cord blood C-peptide was 11.05%.

Conclusion: Maternal SSD during pregnancy was continuously associated with an increased incidence of neurodevelopmental delay with sex differences among offspring. This association may be mediated in part by increased higher levels of cord C-peptide.

Keywords: neurodevelopmental delay; offspring; pregnancy; sex differences; short sleep duration.

摘要

背景：为了研究怀孕期间睡眠时间短（SSD）与后代神经发育迟缓的关系，旨在为妊娠睡眠指南提供信息并促进孕产妇健康和儿童发育。

目的： 确定妊娠期 SSD 与子代神经发育迟缓之间的相关性，并确定胎儿葡萄糖代谢是否在SSD和神经发育迟缓中发挥作用。

方法：该队列研究跟踪了合肥母婴健康队列的7 059对母子，并通过匹兹堡睡眠质量指数收集了第24至28周和第32至36周的怀孕期间的睡眠数据。通过丹佛发育筛查测试II和格赛尔发育诊断量表评估产后6至36个月的神经发育结局。采用Cox比例风险回归分析母体SSD与神经发育迟缓风险之间的联系。采用中介分析评价脐带血血清C肽水平的作用。合肥市的三家医院和儿童健康中心参与其中。

结果：分层分析显示，妊娠中期SSD母亲与男孩神经发育迟缓之间存在显著相关性（校正HR＝2.05，95% CI＝1.29～3.25）。脐带血标志物分析显示脐带血血清C肽水平与后代神经发育迟缓呈正相关（RR＝0.04，95% CI＝0.00～0.08）。脐带血C肽介导的SSD与神经发育迟缓的关联比例为11.05%。

结论： 孕期母体SSD与后代性别差异神经发育迟缓发生率增加持续相关。这种关联可能部分是由高水平的脊髓C肽增加介导的。

关键词：神经发育迟缓；后代；怀孕；性别差异；睡眠时间短