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Sleep characteristics modify the associations of physical activity during pregnancy and gestational weight gain

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

Excessive gestational weight gain (eGWG) is associated with adverse long-term maternal outcomes. Most lifestyle interventions that incorporate physical activity have been ineffective at reducing eGWG. The purpose of this study was to determine if sleep modified the relationships between physical activity change from the 2nd to 3rd trimester and the odds of excessive gestational weight gain (eGWG).

Methods

This was a secondary data analysis of a prospective cohort study of pregnant birthing people with overweight or obesity (n = 105). We estimated physical activity energy expenditure (PAEE) in the 2nd and 3rd trimesters of pregnancy and sleep characteristics (i.e., sleep quality, daytime dysfunction, sleep efficiency, sleep duration) in the 2nd trimester of pregnancy with validated measures. We used regression models with sleep and PAEE change (increase/stable vs. decrease) interaction terms to examine the impact of sleep on PAEE change and eGWG.

Results

Mean GWG was 37.02 ± 16.76 lbs. and 80% of participants experienced eGWG. Eighteen percent of participants increased their PAEE from the 2nd to the 3rd trimester. Increasing (vs. decreasing) PAEE was associated with lower log-odds of eGWG only among participants that slept at least 8 h/night (p = 0.06), had at least 85% sleep efficiency (p = 0.03), or reported less daytime dysfunction (p = 0.08). Sleep quality did not moderate the association between PAEE change and eGWG.

Conclusions

Weight management interventions in pregnancy should consider screening for and addressing poor sleep in the second trimester.

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Funding

This work was funded by NICHD (R01 HD068802); KL2 TR001856-03 supported Dr. Hawkins.

Author information

Authors and Affiliations

  1. Department of Epidemiology, University of Pittsburgh, 5138 Public Health, Pittsburgh, PA, 15261, USA

    Marquis S. Hawkins

  2. Department of Psychiatry, University of Pittsburgh, 5138 Public Health, Pittsburgh, PA, 15261, USA

    Rachel K. Conlon, Daniel J. Buysse, Elizabeth M. Venditti & Michele D. Levine

  3. Department of Psychology, University of Pittsburgh, 5138 Public Health, Pittsburgh, PA, 15261, USA

    Shannon Donofry

  4. Department of Statistics, University of Pittsburgh, 5138 Public Health, Pittsburgh, PA, 15261, USA

    Yu Cheng

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  1. Marquis S. Hawkins
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  2. Rachel K. Conlon
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  4. Daniel J. Buysse
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Contributions

MSH contributed to the conception of the work, data analysis and interpretation, drafting and revising the work; RPC contributed to the data interpretation and revising the work. SD contributed to the data interpretation and revising the work; DJB contributed to the data interpretation and revising the work; EMV contributed to the data interpretation and revising the work; YC contributed to the data interpretation and revising the work; MDL contributed to the data acquisition, conception of the work, data interpretation, and revising the work. All authors approved the final version to be published.

Corresponding author

Correspondence to Marquis S. Hawkins.

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Conflict of interest

Over the past five years, Buysse has served as a paid consultant to Bayer, BeHealth Solutions, Cereve/Ebb Therapeutics, Emmi Solutions, National Cancer Institute, Pear Therapeutics, Philips Respironics, Sleep Number, Idorsia, and Weight Watchers International. He has served as a paid consultant for professional educational programs developed by the American Academy of Physician Assistants and CME Institute and received payment for a professional education program sponsored by Eisai (content developed exclusively by Buysse). Buysse is an author of the Pittsburgh Sleep Quality Index, Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A), Brief Pittsburgh Sleep Quality Index (B-PSQI), Daytime Insomnia Symptoms Scale, Pittsburgh Sleep Diary, Insomnia Symptom Questionnaire, and RU_SATED (copyright held by the University of Pittsburgh). These instruments have been licensed to commercial entities for fees. He is also co-author of the Consensus Sleep Diary (copyright held by Ryerson University), licensed to commercial entities for a fee. He has received grant support from NIH, PCORI, AHRQ, and the VA. Over the past three years, Buysse has served as a paid consultant to National Cancer Institute, Pear Therapeutics, Sleep Number, Idorsia, and Weight Watchers International. None of the authors have conflicts of interest to disclosure except for Dr. Daniel Buysse, who reported his conflicts in the attached ICMJFE disclosure form.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hawkins, M.S., Conlon, R.K., Donofry, S. et al. Sleep characteristics modify the associations of physical activity during pregnancy and gestational weight gain. Arch Gynecol Obstet 308, 101–109 (2023). https://doi.org/10.1007/s00404-022-06677-z

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