Objective: To explore the relationship between maternal sleep in the third trimester and 10-year risk of cardiovascular disease(CVD).
Methods: From March 2015 to July 2020, a total of 3034 pregnant women aged 18 to 45 years old with single pregnancy at the gestational age of 28 to 40 weeks in 3 hospitals in Hefei were enrolled in the study. Questionnaire survey was conducted to collect general demographic characteristics, lifestyles and sleep status. Total cholesterol(TC) and high-density lipoprotein cholesterol(HDL-C) were measured in venous blood. Restricted cubic spline regression model, Logistic regression model and stratified analysis were used to explore the association between sleep status and 10-year CVD risk.
Results: In the third trimester, the average sleep duration was(7.6±1.1) hours and the proportion of bedtime ≥22:00 was 82.7%. Sleep midpoint ≥02:30 accounted for 66.4% and wake up ≥07:00 accounted for 57.6%. The 10-year CVD risk prediction was(2.03±1.86)% and high-risk accounted for 10%(303 cases). In the restricted cubic spline regression, night sleep duration, bedtime, and getup with 10-year CVD risk had a downward trend(P<0.001). Logistic regression model result showed that short sleep duration(less than 8 hours) and wake up early(before 07:00 o'clock) and sleep midpoint before 02:30 was associated with a significantly higher 10-year CVD risk(OR=1.35, 95%CI 1.05-1.75;OR=2.23, 95%CI 1.71-2.90;OR=1.63, 95%CI 1.26-2.11). Further stratified analysis found that only among pregnant women with later bedtime(after 22:00 o'clock), short sleep duration(less than 8 hours) and wake up early(before 07:00 o'clock) and sleep midpoint before 02:30 was associated with significantly increased 10-year CVD risk(OR=1.53, 95%CI 1.14-2.05;OR=2.44, 95%CI 1.81-3.28;OR=1.85, 95%CI 1.37-2.50).
Conclusion: In the third trimester, exposure to shorter sleep duration(less than 8 hours) or wake up early(before 07:00 o'clock) or sleep midpoint before 02:30 may increase the risk of 10-year CVD risk, in particular, for the pregnant women later bedtime(after 22:00 o'clock).
Keywords: cardiovascular risk; sleep; third trimester.