Shift work and sleep duration are associated with adverse pregnancy outcomes in a predominantly Latinx population with high rates of obesity

PLoS One. 2022 Aug 4;17(8):e0272218. doi: 10.1371/journal.pone.0272218. eCollection 2022.


Background: Shift work has been associated with adverse pregnancy outcomes. The objective of this study was to evaluate the association between sleep disturbances and adverse pregnancy outcomes.

Methods and findings: This was a secondary analysis of a prospective study of participants enrolled in a prospective observational study wherein gravidae were screened for sleep apnea (2010-2012). A screening questionnaire with standard sleep apnea questionnaires as well as novel items about shift work and nocturnal sleep duration was administered at a prenatal care visit. Short sleep duration was defined as less than 7 hours. Prolonged sleep duration was defined as greater than 9 hours. In a cohort of 1125 pregnant people, 9.4% reported shift work at the time of screening. Gravidae who reported shift work were more likely than gravidae who reported no shift work to develop preeclampsia (28.3% versus 13.0%, P<0.001), preeclamspsia with severe features (16.0% versus 8.5%, P = 0.010), gestational diabetes (28.3% versus 19.9%, P = 0.041), and a composite of adverse obstetric outcomes (61.3% versus 47.8%, P = 0.008). After adjusting for potentially confounding variables, shift work was associated with an increased risk for preeclampsia with (adjusted relative risk (aRR) 1.70, 95% CI 1.03-2.79, p = 0.036) and without (aRR 2.03, 95% CI 1.43-2.90, p<0.001) severe features, and gestational diabetes mellitus class A1 (aRR 1.47, 95% CI 1.05-2.05, p = 0.023) and class A2 (aRR 1.67, 95% CI 1.13-2.44, p = 0.009). Sleep duration was associated with gestational diabetes (31.3% among those with short sleep duration, 25.2% among those with normal sleep duration and 14.0% among those with prolonged sleep duration, P<0.001) and gestational diabetes class A2 (29.5%, 17.9%, and 10.1%, respectively, P<0.001). Gravidae with prolonged sleep duration experienced less composite adverse pregnancy outcomes at 42.6% compared to 57.4% for those with short sleep duration or 52.5% for those with normal sleep duration, P = 0.002.

Conclusions: Shift work and sleep duration are both associated with adverse pregnancy outcomes. Further research on the impact of sleep disturbance on pregnancy outcomes is warranted.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes, Gestational* / diagnosis
  • Female
  • Humans
  • Obesity / complications
  • Pre-Eclampsia* / epidemiology
  • Pregnancy
  • Pregnancy Complications* / diagnosis
  • Pregnancy Complications* / epidemiology
  • Pregnancy Outcome / epidemiology
  • Prospective Studies
  • Sleep
  • Sleep Apnea Syndromes* / complications
  • Sleep Wake Disorders* / complications
  • Sleep Wake Disorders* / diagnosis
  • Sleep Wake Disorders* / epidemiology

Grants and funding

JML: Received support from the Herman and Gwendolyn Shapiro Foundation. MHB: General research support, School of Medicine and Public Health, University of Wisconsin-Madison, Department of Neurology. KMA: Resident research funds from Baylor College of Medicine. KMA: General research support, School of Medicine and Public Health, University of Wisconsin-Madison, Department of Obstetrics and Gynecology. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.