母亲孕期睡眠时间短可能会增加子女神经发育迟缓的风险

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

Author: 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: The Journal of clinical endocrinology and metabolism

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.

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

Design: This cohort study followed 7,059 mother‒child pairs from the MIH-Hefei cohort, and collected sleep data during pregnancy via the Pittsburgh Sleep Quality Index (PSQI) at weeks 24-28 and 32-36. 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.

Results: The stratified analysis revealed a significant association between the mothers with the SSD during mid-pregnancy and neurodevelopmental delay in boys [adjusted HR with 95% CI: 2.05 (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 with 95% CI: 0.04 (0.00, 0.08)]. The proportion of the association between SSD and neurodevelopmental delay mediated by cord blood C-peptide was 11.05%.

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

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

摘要

背景：为了研究孕期睡眠时间短（SSD）与后代神经发育迟缓的关系，我们旨在为孕期睡眠指南提供信息，促进孕产妇健康和儿童发育。

研究目的：确定孕期睡眠时间短与后代神经发育迟缓之间的关系。确定胎儿糖代谢是否在SSD和神经发育迟缓中起作用。

设计：这项队列研究跟踪了来自合肥市母婴队列的 7059 对母婴，并通过匹兹堡睡眠质量指数量表（PSQI）测量了孕期第 24-28 周和 32-36 周母亲的睡眠数据。产后6至36个月的神经发育结果通过丹佛发育筛查测试II和Gesell发育诊断量表进行评估。Cox 比例风险回归用于分析产妇 SSD 与神经发育延迟风险之间的联系。中介分析用于评估脐带血血清C肽的作用。

研究结果：分层分析显示，孕中期患 SSD 的母亲与男童神经发育迟缓之间存在显著关联[调整后 HR（95% CI）：2.05 (1.29, 3.25)]。脐带血标记物的分析显示，脐带血血清C肽水平与后代神经发育迟缓风险呈正相关[RR，95% CI：0.04 (0.00, 0.08)]。由脐带血C肽介导的SSD与神经发育迟缓之间的关系比例为11.05%。

结论：妊娠期母体SSD与后代神经发育迟缓发生率的增加持续相关，且存在性别差异。这种关联的部分原因可能是脐带血C肽水平升高。