Sleep Disturbances Before Pregnancy and Subsequent Risk of Gestational Diabetes Mellitus

Yifan Song,1,&ast; Liping Wang,2,&ast; Danni Zheng,3,4 Lin Zeng,5 Yan Wang3,4 1Department of General Practice, Peking University Third Hospital, Beijing, 100191, People’s Republic of China; 2Department of Neurology, Peking University Third Hospital, Beijing, 100191, People’s Republic of China; 3Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, People’s Republic of China; 4National Clinical Research Center for Obstetrics and Gynecology, Beijing, 100191, People’s Republic of China; 5Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yan Wang, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100026, People’s Republic of China, Tel +13311165106, Email wjgqhn@263.net Lin Zeng, Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, People’s Republic of China, +86 13811401686, Email zlwhy@163.comPurpose: To investigate the relationship between sleep disturbances before pregnancy and the subsequent risk for gestational diabetes mellitus (GDM).Patients and Methods: Pregnant women who attended antenatal clinic before the 12th gestational week between September 2019 and June 2020 were enrolled. The sleep status at the month before the last menstrual period was collected by filling the Pittsburgh Sleep Quality Index (PSQI) and Berlin Questionnaire (BQ) to evaluate the sleep duration, quality and the risk of obstructive sleep apnea (OSA). With monthly antenatal care, the oral glucose tolerance test (OGTT) was performed during 24– 28 gestational weeks. According to the results, GDM and non-GDM group were classified. The sleep status and baseline characters were compared between the two groups.Results: A total of 355 pregnant women were enrolled in this study, and 63 of them (17.7%) were diagnosed with GDM. Univariate analysis showed that maternal age, body mass index (BMI), family history of diabetes, PSQI score and positive BQ were associated with GDM (p < 0.05). Maternal age (aOR 1.10, 95% CI, 1.01– 1.17), BMI before pregnancy (aOR 1.12, 95% CI, 1.02– 1.23), family history of diabetes (aOR 2.35, 95% CI, 1.33– 4.17), positive BQ (aOR 4.03, 95% CI, 1.04– 15.63) were independent risk factors for GDM in multivariate analysis. The decision tree indicated that among the pregnant women with BMI > 20.6 kg/m2 and age > 28.5, the risk for GDM with positive BQ increased from 27.5% to 66.7%.Conclusion: The high risk of OSA before pregnancy may increase the risk for GDM during pregnancy.Graphical Abstract: Keywords: sleep, gestational diabetes mellitus, obstructive sleep apnea, women