Sleeping late with Gestational Diabetes may increase Risk of Pregnancy Complications

Compared with other pregnant women with gestational diabetes, those with a preference for evening activity had three times higher chance of having pre-eclampsia and four times the rate of their newborns being treated in a neonatal intensive care unit. The previously understood link between circadian rhythm disorders and diabetes has been well-defined. However, the influence of chronotype on maternal and fetal complication development during GDM pregnancy needs further studies. Therefore, Dr Cristina F. Sampaio Facanha, MD and colleagues conducted a study to evaluate the chronotype influences in pregnancy complications among women with gestational diabetes and their newborns.

It was a prospective cohort assessment that included clinical data and behaviour questionnaires collected via interview. Researchers included a total of 305 women with gestational diabetes during the second and third trimesters of pregnancy. The women completed questionnaires about their chronotype preferences, sleep quality, daytime sleepiness and symptoms of depression. Among 305 women, they noted 151 women had a morning chronotype, 21 women had the evening chronotype and the remaining 133 participants had no strong chronotype and were classified as having an intermediate type. Dr Facanha and colleagues additionally obtained patient sleep diaries and actigraphic records.

Key findings of the study were:

• Upon analysis, the researchers found that evening preference patients were younger (P <.005), experienced worse sleep quality (P = .02), latter sleep midpoint (P = .01), and had a greater prevalence of insomnia (P <.005) and depression (P = .004) before and during their pregnancy.
• They observed an association between evening type preference among GDM patients and pre-eclampsia (P = .02) and NICU admission (P = .03) during pregnancy.
• Even after controlling for depression symptoms and sleep variables, the researchers found a significant association between evening chronotype and pre-eclampsia.

Facanha suggested that women with gestational diabetes should receive screening to determine their chronotype using a simple questionnaire as part of routine prenatal care, "it might be helpful in the prediction of complications in pregnancy," she added.

"Women may be able to reduce their evening preference," Facanha said. "A change in habits and increased exposure to morning natural light, exercise and a reduction in blue screen light is an accessible form of treatment that can potentially improve health measures in pregnancy."

For further information:

The Endocrine Society