Duration and mode of delivery: Does maternal sleep matter?

Abstract

<h3>Objective</h3><p>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.</p><h3>Methods</h3><p>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.</p><h3>Results</h3><p>In mid-pregnancy, poor sleep quality was associated with a longer first stage (436 vs. 399 min, <em>P</em> = 0.027) and overall duration of delivery (468 vs. 431 min, <em>P</em> = 0.034). In late pregnancy, short sleep duration (<6 h) (adjusted odds ratio [aOR] 2.57, 95% confidence interval [CI]: 1.15–5.72, <em>P</em> = 0.021) and poor sleep quality (aOR 1.68, 95% CI: 1.17–2.41, <em>P</em> = 0.005) were linked to an increased likelihood of unplanned cesarean section. Poor sleep quality (aOR 2.60, 95% CI: 1.52–4.46, <em>P</em> < 0.001) and frequent nocturnal awakenings (aOR 1.72, 95% CI: 1.01–2.89, <em>P</em> = 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, <em>P</em> = 0.018). At delivery, poor sleep quality remained associated with planned cesarean section (aOR 1.99, 95% CI: 1.04–3.82, <em>P</em> = 0.037). In longitudinal analyses, persistent insomnia and sleepiness were not associated with duration or mode of delivery.</p><h3>Conclusion</h3><p>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.</p>