A PROSPECTIVE ANALYSIS OF A COMPREHENSIVE APPROACH TO PREVENTING COMPLICATIONS DURING PREGNANCY AND CHILDBIRTH IN WOMEN WITH SLEEP DISORDERS: INSIGHTS FROM A COHORT STUDY

A PROSPECTIVE ANALYSIS OF A COMPREHENSIVE APPROACH
TO PREVENTING COMPLICATIONS DURING PREGNANCY AND
CHILDBIRTH IN WOMEN WITH SLEEP DISORDERS: INSIGHTS
FROM A COHORT STUDY

OBJECTIVE: This study aims to conduct a prospective analysis of a compre-
hensive approach to preventing complications during pregnancy and childbirth in
women with sleep disorders. We utilized a developed set of interventions based on
data from an adapted questionnaire, examining a cohort of 495 pregnant patients
and parturients.
METHODS: Between 2021 and 2023, a survey was conducted on pregnant
and birthing women at the clinical facilities of the OB/GYN dept. #1 (Shupyk
NHUU, Kyiv), comprising 495 participants. The adapted PSQI questionnaire was
employed to categorize women into three groups based on the presence or absence
of sleep disorders. The main group (n=175) received therapy to improve sleep
quality, while the comparison group (n=178) had sleep disorders without med-
ical intervention. The control group (n=142) exhibited no sleep disorders. The
PSQI-P questionnaire was used to investigate pregnancy and childbirth charac-
teristics (e.g., anemia, threatened abortion, preterm birth risk, preeclampsia, ges-
tational diabetes, fetal growth retardation, fetal distress, obstetric complications,
cesarean section rate, prematurity, postpartum hemorrhage), as well as their cor-
relation with sleep disorder parameters (e.g., sleep quality, duration, efficiency,
and insomnia severity) in pregnant women. For a comprehensive sleep quality
assessment, we additionally employed the Insomnia Severity Index (ISI) and the
Epworth Sleepiness Scale (ESS). To prevent complications during pregnancy and
childbirth, we devised a set of interventions based on a literature review, incorpo-
rating cognitive-behavioral therapy under psychologist supervision, a specialized
electronic app (Sleepio for Pregnancy), sedative medication, and alternative treat-
ments for severe insomnia.

RESULTS: Our research revealed significantly fewer pregnancy complica-
tions (threatened abortion, preterm birth, preeclampsia, gestational diabetes) in
the main group (p<0.05), attributed to the implementation of the treatment and
prevention regimen, compared to the comparison group (without the regimen)
(p<0.05). The frequency of pregnancy and childbirth complications in the main
group did not differ significantly from those in the control group of healthy preg-
nant women without sleep disorders.

CONCLUSIONS: Given the substantial prevalence of sleep disorders among
pregnant and birthing women, contemporary obstetrics seeks an effective approach
to diagnose, prevent, and treat this comorbidity. Our adapted PSQI-P question-
naire more reliably identifies early signs of sleep disturbances in pregnant women.

Our intervention package allows for early prevention of pregnancy and childbirth
complications among women with sleep disorders, potentially reducing perinatal
morbidity.