Am J Perinatol
DOI: 10.1055/s-0044-1780537
SMFM Fellows Research Series

Sleep Quality in Individuals with and without Persistent Postpartum Hypertension

Tiffany L. Wang
1   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania
,
Samantha G. Bryan
2   Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Arundhathi Jeyabalan
1   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania
2   Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Francesca L. Facco
1   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania
,
Robin E. Gandley
2   Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Carl A. Hubel
2   Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Janet M. Catov
2   Magee-Womens Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Alisse K. Hauspurg
1   Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania
› Author Affiliations
Funding This study received financial support from the Amy Roberts Award from Magee-Womens Research Institute, and the Jewish Healthcare Foundation. This work was additionally supported by NIH/ORWH Building Interdisciplinary Research Careers in Women's Health NIH K12HD043441 scholar funds (to A.K.H.) and the American Heart Association Go Red for Women Strategic Focused Research Network (contract AHA 16SFRN28340000).

Clinical Trials Registrations Clinicaltrials.gov Number: NCT03749746

Abstract

Objective This study aimed to compare sleep quality at 1 year postpartum following a hypertensive disorder of pregnancy (HDP) among individuals with persistent postpartum hypertension (HTN) compared with those with normal blood pressures (BPs).

Study Design We combined data from the Heart Health 4 New Moms pilot randomized trial (n = 118) and the Pathways prospective cohort study (n = 36). Individuals with a singleton pregnancy complicated by gestational HTN or preeclampsia underwent a research study visit at a mean 48.7 ± 9.5 weeks postpartum with standardized BP measurement and assessment of subjective sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Persistent postpartum HTN was defined as Stage 1 HTN or greater (mean systolic BP ≥ 130 mm Hg or mean diastolic BP ≥ 80 mm Hg over three measurements at rest) or requiring antihypertensive medication. Statistical analysis was performed using univariate and multivariable logistic regression analyses.

Results Of 154 individuals with an HDP included in the analysis, 84 (55%) were normotensive at 1 year postpartum and 70 (45%) had persistent postpartum HTN. Individuals with persistent postpartum HTN were more likely to be older, self-identify as Black race, have higher prepregnancy and 1-year postpartum body mass index (BMI), be multiparous, and deliver at an earlier gestational age. The mean global PSQI score was 8.7 ± 3.7, with 81% reporting poor sleep (PSQI > 5), and scores were higher among individuals who were persistently hypertensive (9.6 ± 3.5) compared with those who were normotensive at 1 year postpartum (7.9 ± 3.6), p < 0.01. Findings were unchanged in a multivariable model adjusting for age, self-reported race, prepregnancy BMI, and parity.

Conclusion Following an HDP, individuals reported poor sleep quality at 1 year postpartum. Individuals with persistent postpartum HTN reported lower sleep quality, suggesting that sleep behavior may be a target for intervention to improve maternal cardiovascular health following an HDP.

Key Points

  • After an HDP, poor sleep quality was common at 1 year postpartum.

  • Those with persistent postpartum HTN reported worse sleep quality at 1 year postpartum.

  • Sleep behavior may be a target for intervention to improve maternal cardiovascular health.

Supplementary Material

Please see the Supplementary Material for additional data on sleep-disordered breathing questions from the Pittsburgh Sleep Quality Index and data on the control individuals from the Pathways prospective cohort.


Note

The results of this study were presented at the virtual Society for Maternal-Fetal Medicine's 42nd Annual Pregnancy Meeting in February 2022.


Supplementary Material



Publication History

Received: 15 June 2023

Accepted: 28 January 2024

Article published online:
19 February 2024

© 2024. Thieme. All rights reserved.

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