Int J Gynaecol Obstet. 2025 Nov 20. doi: 10.1002/ijgo.70673. Online ahead of print.

ABSTRACT

OBJECTIVE: Poor sleep quality in late pregnancy has been identified as a risk factor for operative deliveries. In this study, we investigated the associations between maternal sleep throughout pregnancy and its impact on both the duration and mode of delivery.

METHODS: We enrolled 3141 mothers and assessed sleep at four time points during pregnancy (early, mid-, and late pregnancy, and at delivery) using the Basic Nordic Sleep Questionnaire. Delivery data were obtained from the Finnish Birth Registry. Both longitudinal and cross-sectional analyses were performed, adjusting for confounding factors.

RESULTS: In mid-pregnancy, poor sleep quality was associated with a longer first stage (436 vs. 399 min, P = 0.027) and overall duration of delivery (468 vs. 431 min, P = 0.034). In late pregnancy, short sleep duration (<6 h) (adjusted odds ratio [aOR] 2.57, 95% confidence interval [CI]: 1.15-5.72, P = 0.021) and poor sleep quality (aOR 1.68, 95% CI: 1.17-2.41, P = 0.005) were linked to an increased likelihood of unplanned cesarean section. Poor sleep quality (aOR 2.60, 95% CI: 1.52-4.46, P < 0.001) and frequent nocturnal awakenings (aOR 1.72, 95% CI: 1.01-2.89, P = 0.042) were associated with planned cesarean section, while habitual awakenings also increased the risk of vacuum extraction (aOR 1.45, 95% CI: 1.07-1.96, P = 0.018). At delivery, poor sleep quality remained associated with planned cesarean section (aOR 1.99, 95% CI: 1.04-3.82, P = 0.037). In longitudinal analyses, persistent insomnia and sleepiness were not associated with duration or mode of delivery.

CONCLUSION: Maternal sleep is associated with the mode, but not with the duration of the delivery. Poor and short sleep during late pregnancy is related to instrumental deliveries.

PMID:41263454 | DOI:10.1002/ijgo.70673