Poor sleep health in late pregnancy linked to higher childhood obesity risk

New research has found that mothers with poor sleep quality in late pregnancy had babies with lower weight in the first 6 months of life, but higher weight after age 1-2 years. This effect was strongest in male infants and in babies born at term. The findings from the study in the American Journal of Preventive Medicine, published by Elsevier, suggest that incorporating sleep quality assessments into routine prenatal care could facilitate early identification of at-risk pregnancies, and addressing poor sleep quality could be beneficial for the health of both mother and child.

Sleep health in pregnancy and childhood obesity are two major and modifiable public health concerns. Global childhood and adolescent obesity rates have more than doubled from 1990 to 2022, now affecting more than 390 million children aged 5-19 years.

Studies have found that poor sleep health is associated with various health conditions, including diabetes, obesity, and cardiovascular diseases. Human and animal studies have also suggested that pregnancy sleep quality can serve as a factor in the intergenerational transmission of obesity risk from mother to child.

Rapid weight gain during infancy is a risk factor for obesity in later childhood. Understanding the effects of pregnancy sleep health on early childhood growth trajectories could help mitigate impacts on children's metabolic health.

Most previous research has been cross-sectional or conducted in children over 2 years old. Furthermore, the association between pregnancy sleep health and childhood obesity has not been extensively studied in Hispanic populations in the US, which have higher rates of being overweight or obese compared to other racial or ethnic groups.

This study investigated a group of 645 mother-child pairs from the prospective pregnancy cohort Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) in Los Angeles. Researchers evaluated late-pregnancy sleep quality using the Jenkins Sleep Scale questionnaire. Height and weight of children were measured at follow-up visits at the University of Southern California clinic or abstracted from medical records.

Most mothers reported mild to moderate sleep disturbance but 26% of mothers had poor sleep quality. Children whose mothers reported the worst sleep quality had lower weights from birth to 6 months but had higher weights thereafter. At 1 year of age, the difference in weight was 346.7 grams, and the greatest difference was observed at 17 months (751.5 grams).

The study underscores the importance of maintaining good pregnancy sleep health. The findings suggest that the observed associations are primarily driven by poor late-pregnancy sleep quality and are not explained by other traditionally identified prenatal and postnatal factors such as childhood feeding practices.

Senior author Carrie V. Breton, MPH, PhD, Professor at the Bursky School of Public Health, Washington University in St. Louis, and Adjunct Professor in the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, says, "Our research supports the notion that exposures during critical developmental windows of pregnancy can program offspring health. Several biological mechanisms may link late-pregnancy sleep health to children's weight trajectories. For instance, poor sleep may affect maternal or child metabolic health programming, or both, which in turn could affect neonatal fat mass distribution and lead to abnormal lipid profiles or higher inflammation. Alternatively, stress pathways associated with higher childhood obesity risk may also play a role."

Poor sleep health in pregnancy is common and often overlooked, and our findings suggest that monitoring it in routine prenatal care could be a simple and powerful step toward healthier growth for the next generation."

Xiaoran Yang, MPH, lead author, PhD graduate from the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California