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BMC Medicine
Published in: BMC Medicine 1/2022

Open Access 01-12-2022 | Research article

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

Authors: Jiajun Lyu, John A. Groeger, Anna L. Barnett, Haifeng Li, Lei Wang, Jiajia Zhang, Wenchong Du, Jing Hua

Published in: BMC Medicine | Issue 1/2022

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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 have 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, has 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.
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Metadata
Title
Associations between gestational age and childhood sleep: a national retrospective cohort study
Authors
Jiajun Lyu
John A. Groeger
Anna L. Barnett
Haifeng Li
Lei Wang
Jiajia Zhang
Wenchong Du
Jing Hua
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2022
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-022-02443-9

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