TY - JOUR
T1 - Preconception sleep duration, sleep timing, and shift work in association with fecundability and live birth among women with a history of pregnancy loss
AU - Freeman, Joshua R.
AU - Whitcomb, Brian W.
AU - Bertone-Johnson, Elizabeth R.
AU - Balzer, Laura B.
AU - O'Brien, Louise M.
AU - Dunietz, Galit L.
AU - Purdue-Smithe, Alexandra C.
AU - Kim, Keewan
AU - Silver, Robert M.
AU - Schisterman, Enrique F.
AU - Mumford, Sunni L.
N1 - Publisher Copyright:
© 2022
PY - 2023/2
Y1 - 2023/2
N2 - Objective: To evaluate the associations between preconception sleep characteristics and shift work with fecundability and live birth. Design: Secondary analysis of the Effects of Aspirin in Gestation and Reproduction study, a preconception cohort. Setting: Four US academic medical centers. Patient(s): Women aged 18–40 with a history of 1–2 pregnancy losses who were attempting to conceive again. Intervention(s): Not applicable. Main Outcome Measures(s): We evaluated baseline, self-reported sleep duration, sleep midpoint, social jetlag, and shift work among 1,228 women who were observed for ≤6 cycles of pregnancy attempts to ascertain fecundability. We ascertained live birth at the end of follow up via chart abstraction. We estimated fecundability odds ratios (FORs) using discrete, Cox proportional hazards models and risk ratios (RRs) for live birth using log-Poisson models. Result(s): Sleep duration ≥9 vs. 7 to <8 hours (FOR: 0.81, 95% confidence interval [CI], 0.61; 1.08), later sleep midpoints (3rd tertile vs. 2nd tertile: FOR: 0.85; 95% CI, 0.69, 1.04) and social jetlag (continuous per hour; FOR: 0.93, 95% CI: 0.86, 1.00) were not associated with reduced fecundability. In sensitivity analyses, excluding shift workers, sleep duration ≥9 vs. 7 to <8 hours (FOR: 0.62; 95% CI, 0.42; 0.93) was associated with low fecundability. Night shift work was not associated with fecundability (vs. non-night shift work FOR: 1.17, 95% CI, 0.96; 1.42). Preconception sleep was not associated with live birth. Conclusion(s): Overall, there does not appear to be a strong association between sleep characteristics, fecundability, and live birth. Although these findings may suggest weak and imprecise associations with some sleep characteristics, our findings should be evaluated in larger cohorts of women with extremes of sleep characteristics. Clinical Trial Registration Number: Clinicaltrials.gov NCT00467363.
AB - Objective: To evaluate the associations between preconception sleep characteristics and shift work with fecundability and live birth. Design: Secondary analysis of the Effects of Aspirin in Gestation and Reproduction study, a preconception cohort. Setting: Four US academic medical centers. Patient(s): Women aged 18–40 with a history of 1–2 pregnancy losses who were attempting to conceive again. Intervention(s): Not applicable. Main Outcome Measures(s): We evaluated baseline, self-reported sleep duration, sleep midpoint, social jetlag, and shift work among 1,228 women who were observed for ≤6 cycles of pregnancy attempts to ascertain fecundability. We ascertained live birth at the end of follow up via chart abstraction. We estimated fecundability odds ratios (FORs) using discrete, Cox proportional hazards models and risk ratios (RRs) for live birth using log-Poisson models. Result(s): Sleep duration ≥9 vs. 7 to <8 hours (FOR: 0.81, 95% confidence interval [CI], 0.61; 1.08), later sleep midpoints (3rd tertile vs. 2nd tertile: FOR: 0.85; 95% CI, 0.69, 1.04) and social jetlag (continuous per hour; FOR: 0.93, 95% CI: 0.86, 1.00) were not associated with reduced fecundability. In sensitivity analyses, excluding shift workers, sleep duration ≥9 vs. 7 to <8 hours (FOR: 0.62; 95% CI, 0.42; 0.93) was associated with low fecundability. Night shift work was not associated with fecundability (vs. non-night shift work FOR: 1.17, 95% CI, 0.96; 1.42). Preconception sleep was not associated with live birth. Conclusion(s): Overall, there does not appear to be a strong association between sleep characteristics, fecundability, and live birth. Although these findings may suggest weak and imprecise associations with some sleep characteristics, our findings should be evaluated in larger cohorts of women with extremes of sleep characteristics. Clinical Trial Registration Number: Clinicaltrials.gov NCT00467363.
KW - Sleep duration
KW - fecundability
KW - live birth
KW - sleep midpoint
KW - social jetlag
UR - http://www.scopus.com/inward/record.url?scp=85145997126&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85145997126&partnerID=8YFLogxK
U2 - 10.1016/j.fertnstert.2022.10.026
DO - 10.1016/j.fertnstert.2022.10.026
M3 - Article
C2 - 36586812
AN - SCOPUS:85145997126
SN - 0015-0282
VL - 119
SP - 252
EP - 263
JO - Fertility and sterility
JF - Fertility and sterility
IS - 2
ER -