title: Sleep in late pregnancy predicts length of labor and type of delivery.
abstract: OBJECTIVE
  The purpose of this study was to test the hypothesis that fatigue and sleep disturbance in late pregnancy are associated with labor duration and delivery type.
  
  
  METHODS
  In a prospective observational study of 131 women in their ninth month of pregnancy, objective (48-hour wrist actigraphy) and subjective (sleep logs and questionnaires) measures were used to predict labor outcomes using analysis of variance and logistic regression.
  
  
  RESULTS
  Controlling for infant birth weight, women who slept less than 6 hours at night had longer labors and were 4.5 times more likely to have cesarean deliveries. Women with severely disrupted sleep had longer labors and were 5.2 times more likely to have cesarean deliveries. Fatigue was unrelated to labor outcomes.
  
  
  CONCLUSIONS
  Health care providers should prescribe 8 hours of bed time during pregnancy to assure adequate sleep and should include sleep quantity and quality in prenatal assessments as potential predictors of labor duration and delivery type.
authors.affiliation: University of California-San Francisco, School of Nursing, Box 0606, San Francisco, CA 94143, USA. kathryn.lee@nursing.ucsf.edu
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Lee
authors.forename: Caryl L
authors.initials: CL
authors.lastname: Gay
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007747:Labor Stage, First; D007748:Labor Stage, Second; D007743:Labor, Obstetric; D016015:Logistic Models; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology; D013997:Time Factors