Poor Sleep Quality and Associated Inflammation Predict Preterm Birth: Heightened Risk among African Americans

Poor sleep promotes inflammation. In turn, inflammation is a causal mechanism in term as well as preterm parturition. In the United States, a persistent racial disparity in preterm birth exists, with African Americans showing ∼1.5 times greater risk. This study examined associations among sleep qual...

Full description

Saved in:
Bibliographic Details
Published in:Sleep (New York, N.Y.) N.Y.), 2015-08, Vol.38 (8), p.1259-1267
Main Authors: Blair, Lisa M, Porter, Kyle, Leblebicioglu, Binnaz, Christian, Lisa M
Format: Article
Language:English
Subjects:
Adolescent
Adult
African Americans - psychology
African Americans - statistics & numerical data
Cross-Sectional Studies
Europe - ethnology
European Continental Ancestry Group - psychology
European Continental Ancestry Group - statistics & numerical data
Female
Gestational Age
Humans
Infant, Newborn
Inflammation - blood
Inflammation - epidemiology
Inflammation - etiology
Inflammation - immunology
Interleukin-8 - immunology
Interleukins - blood
Poor Sleep Quality and Associated Inflammation Predict Preterm Birth
Pregnancy - blood
Pregnancy - immunology
Pregnancy - physiology
Pregnancy - psychology
Premature Birth - blood
Premature Birth - epidemiology
Premature Birth - etiology
Premature Birth - immunology
Risk Factors
Sleep - immunology
Sleep Deprivation - blood
Sleep Deprivation - complications
Sleep Deprivation - epidemiology
Sleep Deprivation - immunology
Tumor Necrosis Factor-alpha - blood
United States - epidemiology
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Poor sleep promotes inflammation. In turn, inflammation is a causal mechanism in term as well as preterm parturition. In the United States, a persistent racial disparity in preterm birth exists, with African Americans showing ∼1.5 times greater risk. This study examined associations among sleep quality, serum proinflammatory cytokines, and length of gestation in a racially diverse sample of 138 pregnant women. Observational. Women completed the Pittsburgh Sleep Quality Index (PSQI) and other psychosocial and behavioral measures during midpregnancy. Serum levels of interleukin (IL)-6, IL-8, IL-1β, and tumor necrosis factor (TNF)-α were determined by high-sensitivity assays. Birth outcomes were determined via medical record review. Among African American women (n = 79), shorter gestation was predicted by poorer overall sleep (rs = -0.35, P = 0.002) as well the following PSQI subscales: subjective sleep quality (rs = -0.34, P = 0.002), sleep latency (rs = -0.27, P = 0.02), and sleep efficiency (rs = -0.27, P = 0.02). African American women with poor sleep quality (PSQI > 5) had 10.2 times the odds of preterm birth compared to those with good sleep quality. In contrast, among European American women (n = 53), gestational length was not significantly predicted by sleep quality (Ps > 0.12). Bootstrapping analyses showed that, among African Americans, IL-8 significantly mediated the association between sleep quality and length of gestation (indirect effect estimate -0.029; 95% confidence interval -0.06, -0.002). The data provide novel evidence that African American women exhibit greater inflammation in response to sleep disturbance than European American women and these effects correspond with length of gestation. Racial differences in susceptibility to sleep induced immune dysregulation may contribute to marked racial disparities in preterm birth.
ISSN:0161-8105
1550-9109
DOI:10.5665/sleep.4904