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Clinical Obstetrics

Poster Session 2

(455) Association of Insomnia in Pregnancy with Cardiovascular Health 2-7 years after first birth

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

In the non-pregnant population, insomnia is associated with increased risk of cardiovascular disease. This study examined the association of insomnia during pregnancy and cardiovascular health (CVH) scores 2-7 years after first birth.

Study Design: In this secondary analysis of longitudinal data from a large, diverse cohort of nulliparas conducted at 8 US medical centers, individuals were followed 2-7 years after their first birth. Insomnia symptoms were evaluated via a sleep questionnaire adapted from the 'Women's Health Initiative Insomnia Rating Scale' in early (6-13 weeks’) and mid (22-29 weeks’) pregnancy. A score ≥ 9 indicated clinically significant insomnia. The primary outcome was CVH quantified by the American Heart Association’s Life’s Essential 8 (LE8) score, a validated surrogate of cardiovascular disease risk with lower scores associated with worse CVH. The LE8 score includes diet, physical activity, nicotine exposure, sleep, body mass index, blood pressure, blood glucose, and lipids, and ranges from 0 (worst) to 100 (best). For early and mid pregnancy, a multivariable linear regression analysis was performed adjusting for baseline maternal age, race and ethnicity as a social construct, insurance status, and being at high risk for sleep disordered breathing.

Results: Of 3,453 and 4,123 individuals in early pregnancy and mid pregnancy, insomnia was reported in nearly half of participants (42.3% and 46.6%, respectively). Early and mid pregnancy insomnia symptoms were associated with lower mean LE8 score 2-7 years after first birth. These associations remained significant after covariate adjustment linear regression (Early: 82.8 [SD 11.6] vs. 79.7 [SD 12.9], p < 0.001; β [95% CI] -1.22 [-2.34, -0.10]); Mid: 82.2 [SD 11.9] vs. 79.9 [SD 13.0], p < 0.001; β [95% CI] -1.24 [-2.41, -0.07]).

Conclusion:

Insomnia symptoms, which are common in pregnancy, were associated with worse LE8 scores 2-7 years after first birth, indicating a need for future research understanding how sleep disorders in pregnancy can affect future CVH.