Associations between gestational age and childhood sleep: a national retrospective cohort study

Lyu, J, Groeger, J ORCID: https://orcid.org/0000-0002-3582-1058, Barnett, AL, Li, H, Wang, L, Zhang, J, Du, V ORCID: https://orcid.org/0000-0002-5115-7214 and Hua, J, 2022. Associations between gestational age and childhood sleep: a national retrospective cohort study. BMC Medicine, 20: 353.

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Abstract

Background: Both sleep quality and quantity are essential for normal brain development throughout childhood, however, the association between preterm birth and sleep problems in preschoolers is not yet clear, and the effects of gestational age across the full range from preterm to post-term has not been examined. Our study investigated the sleep outcomes of children born at very-preterm (<31 weeks), moderate-preterm (32-33 weeks), late-preterm (34-36 weeks), early-term (37-38 weeks), full-term (39-40 weeks), late-term (41 weeks), and post-term (>41 weeks).

Methods: A national retrospective cohort study was conducted with 114,311 children aged 3-5 years old in China. Children’s daily sleep hours and pediatric sleep disorders defined by the Children’s Sleep Habits Questionnaire (CSHQ) were reported by parents. Linear regressions and logistic regression models were applied to examine gestational age at birth with the sleep outcomes of children.

Results: Compared with full-term children, a significantly higher CSHQ score, and hence worse sleep, was observed in very-preterm (β=1·827), moderate-preterm (β=1·409), late-preterm (β=0·832), early-term (β=0·233) and post-term (β=0·831) children, all p<0·001. The association of pediatric sleep disorder (i.e. CSHQ scores>41) was also seen in very-preterm (adjusted odds ratio [AOR]=1·287 95% confidence interval [CI] (1·157, 1·433)), moderate-preterm (AOR=1·249 95% CI (1·110, 1·405)), late-preterm (AOR=1·111 95% CI (1·052, 1·174)), and post-term (AOR=1·139 95% CI (1·061, 1·222)), all p<0·001. Shorter sleep duration was also found in very-preterm (β=-0·303), moderate-preterm (β=-0·282), late-preterm (β=-0·201), early-term (β=-0·068), and post-term (β=-0·110) compared with full-term children, all p<0·01. Preterm and post-term born children had different sleep profiles as suggested by subscales of the CSHQ.

Conclusions: Every degree of premature, early-term, and post-term birth, compared to full-term, have an association with sleep disorders and shortened daily sleep duration. Preterm, early-term, and post-term should therefore all be monitored with an increased threat of sleep disorder that requires long-term monitoring for adverse sleep outcomes in preschoolers.

Item Type:	Journal article
Publication Title:	BMC Medicine
Creators:	Lyu, J., Groeger, J., Barnett, A.L., Li, H., Wang, L., Zhang, J., Du, V. and Hua, J.
Publisher:	BioMed Central
Date:	2022
Volume:	20
Identifiers:	Number Type 10.1186/s12916-022-02443-9 DOI 1553412 Other
Rights:	© The Author(s) 2022. Open Access.This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Divisions:	Schools > School of Social Sciences
Record created by:	Linda Sullivan
Date Added:	16 Jun 2022 11:44
Last Modified:	09 Aug 2022 14:22
URI:	https://irep.ntu.ac.uk/id/eprint/46458

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