Poor Sleep Quality in Late Pregnancy Linked to Higher Obesity Risk in Children
Key Takeaways:
- Mothers with poor sleep quality in late pregnancy had babies with lower weight in the first six months of life but higher weight at ages 1–2 years, with the effect strongest in male infants and babies born at term.
- In a study of 645 mother–child pairs, children whose mothers reported the worst sleep quality weighed 346.7 grams (12 ounces) more at age 1, with the greatest difference of 751.5 grams (1.7 pounds) observed at 17 months.
- Researchers suggest that incorporating sleep quality assessments into routine antenatal care could support early identification of at-risk pregnancies, and that addressing poor sleep could benefit the health of both mother and child.
Sleep in pregnancy and early childhood growth
New research has found that mothers who experienced poor sleep quality in late pregnancy had babies who weighed less during the first six months of life but more at ages 1–2 years. This effect was most pronounced in male infants and in babies born at term.
The findings, published in the American Journal of Preventive Medicine, suggest that incorporating sleep quality assessments into routine antenatal care could help healthcare professionals identify at-risk pregnancies earlier. The researchers also suggest that addressing poor sleep quality during pregnancy could benefit the health of both mother and child.
Two modifiable public health concerns
Sleep health in pregnancy and childhood obesity are both major, modifiable public health concerns. Global obesity rates among children and adolescents more than doubled between 1990 and 2022, and obesity now affects more than 390 million children aged 5–19.
Previous studies have found that poor sleep health is associated with a range of health conditions, including diabetes, obesity and cardiovascular disease. Both human and animal studies have also suggested that sleep quality during pregnancy may play a role in the intergenerational transmission of obesity risk from mother to child.
Rapid weight gain during infancy is a recognised risk factor for obesity in later childhood. Understanding how sleep health in pregnancy affects growth trajectories in early childhood could therefore help to mitigate its impact on children’s metabolic health.
Addressing gaps in the evidence
Much of the existing research in this area has been cross-sectional or has focused on children older than 2. In addition, the association between sleep health in pregnancy and childhood obesity has not been studied extensively in Hispanic populations in the US, who experience higher rates of overweight and obesity than other racial or ethnic groups.
How the study was conducted
The study examined 645 mother–child pairs from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) prospective pregnancy cohort in Los Angeles. Researchers assessed late-pregnancy sleep quality using the Jenkins Sleep Scale questionnaire.
Children’s height and weight were either measured during follow-up visits at the University of Southern California clinic or taken from medical records.
Sleep quality and infant weight
Most mothers in the study reported mild to moderate sleep disturbance, while 26% reported poor sleep quality.
Children whose mothers reported the worst sleep quality had lower weights from birth to 6 months, followed by higher weights thereafter. At age 1, the difference in weight was 346.7 grams (12 ounces). The greatest difference was observed at 17 months, at 751.5 grams (1.7 pounds).
The study highlights the importance of good sleep health during pregnancy. According to the researchers, the associations observed appear to be driven primarily by poor sleep quality in late pregnancy and are not explained by other traditionally identified prenatal and postnatal factors, such as feeding practices in childhood.
For healthcare professionals working with families, findings such as these reinforce the value of considering the earliest influences on a child’s weight. The College of Contemporary Health’s Childhood Obesity Essentials CPD course offers a useful grounding for clinicians looking to strengthen their understanding of childhood obesity and the factors that shape it.
Potential biological pathways
Senior author Carrie V. Breton, MPH, PhD, Professor at the Bursky School of Public Health, Washington University in St. Louis, and Adjunct Professor in the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, said:
“Our research supports the notion that exposures during critical developmental windows of pregnancy can program offspring health.
“Several biological mechanisms may link late-pregnancy sleep health to children’s weight trajectories. For instance, poor sleep may affect maternal or child metabolic health programming, or both, which in turn could affect neonatal fat mass distribution and lead to abnormal lipid profiles or higher inflammation. Alternatively, stress pathways associated with higher childhood obesity risk may also play a role.”
Implications for antenatal care
Lead author Xiaoran Yang, MPH, a PhD graduate from the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, added:
“Poor sleep health in pregnancy is common and often overlooked, and our findings suggest that monitoring it in routine prenatal care could be a simple and powerful step toward healthier growth for the next generation.”
CCH insight
Early life offers a crucial window for shaping a child’s long-term weight and metabolic health. Healthcare professionals who support families during pregnancy and early childhood are well placed to recognise risk factors early and help families take preventive steps. Build your confidence in this area with our Childhood Obesity Essentials CPD course.
Explore Childhood Obesity Essentials →
Source: American Journal of Preventive Medicine
