title: Disturbed sleep, a novel risk factor for preterm birth?
abstract: OBJECTIVE
  The etiology of preterm birth (PTB) is likely caused by multiple factors, which may include disturbed sleep. We evaluated whether sleep disturbance was associated with PTB and whether the association was affected by other psychosocial risk factors.
  
  
  METHODS
  Pregnant women (n=217) for whom we had depression and sleep data at 20 or 30 weeks gestation and delivery information were evaluated. Logistic models were used to test the hypotheses that disturbed sleep was associated with PTB.
  
  
  RESULTS
  Time in bed at 20 weeks was significantly associated with risk for preterm delivery (odds ratio [OR] 1.43, 95% confidence interval [CI] 1.08-1.88). However, after controlling for depression/selective serotonin reuptake inhibitors (SSRI) status, history of PTB, age, employment, and marital status, this relationship was no longer significant (OR 1.26, 95% CI .92-1.71). No other relationships were significant.
  
  
  CONCLUSIONS
  We report preliminary evidence suggesting that poor sleep may contribute to risk for PTB. Although it is speculative and additional work is needed to confirm or refute whether sleep is an independent or mediating risk factor for PTB, disturbed sleep does appear to play a role in adverse pregnancy outcomes.
authors.affiliation: Sleep Medicine Institute and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. okunml@upmc.edu
authors.forename: Michele L
authors.initials: ML
authors.lastname: Okun
authors.forename: James F
authors.initials: JF
authors.lastname: Luther
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Wisniewski
authors.forename: Dorothy
authors.initials: D
authors.lastname: Sit
authors.forename: Beth A
authors.initials: BA
authors.lastname: Prairie
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Wisner
mesh_terms: D000328:Adult; D015984:Causality; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000523:psychology; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000453:epidemiology* / Q000523:psychology; D011295:Prenatal Care / Q000379:methods; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult