Association of Supine Going-to-Sleep Position in Late Pregnancy With Reduced Birth Weight: A Secondary Analysis of an Individual Participant Data Meta-analysis.

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dc.contributor.author Anderson, Ngaire en
dc.contributor.author Gordon, Adrienne en
dc.contributor.author Li, Minglan en
dc.contributor.author Cronin, Robin en
dc.contributor.author Thompson, John en
dc.contributor.author Raynes-Greenow, Camille H en
dc.contributor.author Heazell, Alexander EP en
dc.contributor.author Stacey, Tomasina en
dc.contributor.author Culling, Vicki M en
dc.contributor.author Wilson, Jessica en
dc.contributor.author Askie, Lisa M en
dc.contributor.author Mitchell, Edwin en
dc.contributor.author McCowan, Lesley en
dc.date.accessioned 2019-10-29T00:16:22Z en
dc.date.issued 2019-10-02 en
dc.identifier.citation JAMA network open 2(10):e1912614 02 Oct 2019 en
dc.identifier.issn 2574-3805 en
dc.identifier.uri http://hdl.handle.net/2292/48668 en
dc.description.abstract Importance:Supine maternal position in the third trimester is associated with reduced uterine blood flow and increased risk of late stillbirth. As reduced uterine blood flow is also associated with fetal growth restriction, this study explored the association between the position in which pregnant women went to sleep and infant birth weight. Objective:To examine the association between supine position when going to sleep in women after 28 weeks of pregnancy and lower birth weight and birth weight centiles. Design, Setting, and Participants:Prespecified subgroup analysis using data from controls in an individual participant data meta-analysis of 4 case-control studies investigating sleep and stillbirth in New Zealand, Australia, and the United Kingdom. Participants were women with ongoing pregnancies at 28 weeks' gestation or more at interview. Main Outcomes and Measures:The primary outcome was adjusted mean difference (aMD) in birth weight. Secondary outcomes were birth weight centiles (INTERGROWTH-21st and customized) and adjusted odds ratios (aORs) for birth weight less than 50th and less than 10th centile (small for gestational age) for supine vs nonsupine going-to-sleep position in the last 1 to 4 weeks, adjusted for variables known to be associated with birth size. Results:Of 1760 women (mean [SD] age, 30.25 [5.46] years), 57 (3.2%) reported they usually went to sleep supine during the previous 1 to 4 weeks. Adjusted mean (SE) birth weight was 3410 (112) g among women who reported supine position and 3554 (98) g among women who reported nonsupine position (aMD, 144 g; 95% CI, -253 to -36 g; P = .009), representing an approximate 10-percentile reduction in adjusted mean INTERGROWTH-21st (48.5 vs 58.6; aMD, -10.1; 95% CI, -17.1 to -3.1) and customized (40.7 vs 49.7; aMD, -9.0; 95% CI, -16.6 to -1.4) centiles. There was a nonsignificant increase in birth weight at less than the 50th INTERGROWTH-21st centile (aOR, 1.90; 95% CI, 0.83-4.34) and a 2-fold increase in birth weight at less than the 50th customized centile (aOR, 2.12; 95% CI, 1.20-3.76). Going to sleep supine was associated with a 3-fold increase in small for gestational age birth weight by INTERGROWTH-21st standards (aOR, 3.23; 95% CI, 1.37-7.59) and a nonsignificant increase in small for gestational age birth weight customized standards (aOR, 1.63; 95% CI, 0.77-3.44). Conclusions and Relevance:This study found that going to sleep in a supine position in late pregnancy was independently associated with reduced birth weight and birth weight centile. This novel association is biologically plausible and likely modifiable. Public health campaigns that encourage women in the third trimester of pregnancy to settle to sleep on their side have potential to optimize birth weight. en
dc.format.medium Electronic en
dc.language eng en
dc.relation.ispartofseries JAMA network open en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Humans en
dc.subject Birth Weight en
dc.subject Sleep en
dc.subject Pregnancy en
dc.subject Pregnancy Trimester, Third en
dc.subject Supine Position en
dc.subject Adult en
dc.subject Infant, Low Birth Weight en
dc.subject Female en
dc.subject Young Adult en
dc.title Association of Supine Going-to-Sleep Position in Late Pregnancy With Reduced Birth Weight: A Secondary Analysis of an Individual Participant Data Meta-analysis. en
dc.type Journal Article en
dc.identifier.doi 10.1001/jamanetworkopen.2019.12614 en
pubs.issue 10 en
pubs.begin-page e1912614 en
pubs.volume 2 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Meta-Analysis en
pubs.subtype Comparative Study en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 784030 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Obstetrics and Gynaecology en
pubs.org-id Paediatrics Child & Youth Hlth en
dc.identifier.eissn 2574-3805 en
pubs.record-created-at-source-date 2019-10-03 en
pubs.dimensions-id 31577362 en


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