When examining sleep quality, the researchers found that women who reported having poor sleep three to four days per week about three weeks prior to delivery were 4.2 times more likely to then have a cesarean delivery than women who reported having poor sleep two or fewer days per week. Women who reported having poor sleep five or more days per week were 5.3 times more likely to have a cesarean delivery.
"These findings need to be replicated in other studies, but results suggest clinical assessment of sleep quality and quantity as potential predictors of labor duration and delivery type," said Lee.
During the study, each participant was asked to wear a wrist actigraph for a 48-hour period. The actigraph records motion, or sleep disruption, during the night. While wearing the actigraph, participants also recorded their bed times, wake times, and ratings of sleep quality in sleep logs.
Following delivery, participants provided information about their birth experience, including infant's birth weight, duration of labor, and type of delivery. Labor duration was defined as the time from onset of regular contractions to the time of birth. Delivery type was categorized as spontaneous vaginal, assisted vaginal (the use of forceps or vacuum), or cesarean.
Although working women reported spending less time in bed and feeling more fatigued, work status was not associated with labor duration or delivery type. Maternal age was unrelated to labor and delivery outcomes.
"This serves as an important reminder to healthcare providers to discuss the importance of adequate sleep with expectant mothers," added Lee. "Similar to advice that women should 'eat for two' when pregnant, healthcare providers should consider recommending that women also sleep for two."