Worsened birth outcomes with gestational diabetes associated with late nights

Women with gestational diabetes who have a tendency to stay awake longer than average face a much higher risk of pregnancy-related events, according to a new study.

In data presented at ENDO 2021 from a research team in Brazil, pregnant women with preferred gestational diabetes reported evening and late-night activity that had a threefold greater likelihood. the preeclampsia, and a fourfold increase in the likelihood of receiving a neonatal intensive care unit (NICU) treatment.

The research, led by Cristina F. Sampaio Facanha, MD, highlights the potential role of health and sleep quality in expecting mothers who are already managing chronic illness. -gestational sugar.

Facanha and his colleagues noted that gestational diabetes mellitus (GDM) has been a greater problem in pregnancy over the years, with its frequency being associated with increased risks of maternal and fetal pregnancy.

“Circadian rhythm has a major impact on pregnancy and maternal rhythm disorders can disrupt the timely organization of psychological and metabolic activities,” they explained.

The previously understood link between circadian rhythm disorder and diabetes is clearly explained, and now the researchers are quantifying the effects of chronotype on the development of maternal and fetal dysfunction during GDM pregnancy.

Their prospective cohort evaluation included clinical data and behavioral questionnaires collected through interview. Patients were assessed on relevant questionnaires regarding chronotype, sleep quality, daytime sleepiness, depressive symptoms, and insomnia characteristics, including:

  • Morning-Afternoon Questionnaire (MEQ)
  • Pittsburgh Sleep Quality Index (PSQI)
  • Epworth Sleep Scale (ESS)
  • Edinburgh Birth Birth Decline Scale (EDPS)
  • Insomnia Loyalty Index (ISI)

In addition Facanha and colleagues received patient sleep diaries and actigraphic records.

The final assessment included 305 GMD patients in their second or third trimester at the time of assessment. A further 89 patients completed the sleep diary, and 53 completed actigraphic records.

For each MEQ, 49.5% of GDM patients were identified as morning chronotypes; 43.6% as intermediate types; and 6.9% as an evening type choice.

On average, evening preference patients were younger (P. <.005), experience of worse sleep quality (P. = .02), last sleeping center (P. = .01), and insomnia was greater (P. <.005) and depression (P. = .004) before and during pregnancy.

Researchers found an association between evening type preference among GDM patients and pre-eclampsia (P. = .02) and NICU admission (P. = .03) during pregnancy.

In a statement accompanying the team’s findings, Facanha explained the value of the sleep-cycle, especially among the observed population.

“Hormones, blood pressure and glucose, or blood sugar, metabolism follow circadian rhythms that synchronize with a key clock in the brain,” Facanha said. “When the circadian rhythm for the sleep cycle is thrown off, it can not only create sleep problems but can also inhibit glucose metabolism, affecting serious health.”

In closing, Facanha hoped that GDM patients with an option for evening activity will be able to reduce what they want because of their health.

“Changing habits and increased exposure to natural morning light, exercise and a reduction in blue screen light are an accessible treatment that can promote health measures in pregnancy,” she said.

The study, “Maternal Chronotype and Pregnancy Outcomes in Gestational Diabetes,” was presented at ENDO 2021.