Brain, behavior, & immunity - health · 2026
Inflammatory exposures in early pregnancy and multidimensional sleep in late pregnancy: a prospective population-based study.
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Mao Fangxiang, Zarchev Milan, Sun Hong, Mou Yuchan, Gaillard Romy, Schuurmans Isabel K, El Marroun Hanan
Аннотация
BACKGROUND: Sleep problems are common during pregnancy, and inflammation has been proposed as a potential underlying pathway. However, findings remain fragmented because most studies have focused on single inflammation-related exposures or individual sleep components. We therefore prospectively examined multiple inflammatory measures in relation to multidimensional sleep outcomes.
METHODS: Within the population-based Generation R Next cohort, inflammation was assessed in early pregnancy by (a) a composite score of self-reported infection-related conditions (n = 1134), (b) peripheral inflammatory markers including a cytokine index and hs-CRP (n = 432), and (c) dietary inflammatory potential indexed by the Dietary Inflammatory Index (DII) (n = 852). Sleep in late pregnancy was assessed by validated questionnaires including duration, latency, midpoint, quality, awakenings, difficulties initiating sleep, and daytime sleepiness. Associations were examined using Bayesian multivariate models that accounted for correlations among sleep components and estimated an overall sleep effect. We further tested the effect modification by body mass index.
RESULTS: Associations between inflammation in early pregnancy and sleep in late pregnancy differed across inflammation-related exposures. Self-reported infections were associated with poorer overall sleep (β = 0.06, 95%CrI = [0.03,0.09]). No associations were found for the cytokine index, hs-CRP, or DII and overall sleep. At individual sleep component level, associations were most evident for sleep quality and daytime sleepiness. Several associations between inflammation-related exposures and individual sleep components differed in direction and strength between women with overweight or obesity.
CONCLUSIONS: Associations between inflammation and sleep during pregnancy were heterogeneous across inflammation-related exposures, sleep components, and BMI status. These findings support a multidomain inflammatory framework for understanding multidimensional sleep health during pregnancy.
METHODS: Within the population-based Generation R Next cohort, inflammation was assessed in early pregnancy by (a) a composite score of self-reported infection-related conditions (n = 1134), (b) peripheral inflammatory markers including a cytokine index and hs-CRP (n = 432), and (c) dietary inflammatory potential indexed by the Dietary Inflammatory Index (DII) (n = 852). Sleep in late pregnancy was assessed by validated questionnaires including duration, latency, midpoint, quality, awakenings, difficulties initiating sleep, and daytime sleepiness. Associations were examined using Bayesian multivariate models that accounted for correlations among sleep components and estimated an overall sleep effect. We further tested the effect modification by body mass index.
RESULTS: Associations between inflammation in early pregnancy and sleep in late pregnancy differed across inflammation-related exposures. Self-reported infections were associated with poorer overall sleep (β = 0.06, 95%CrI = [0.03,0.09]). No associations were found for the cytokine index, hs-CRP, or DII and overall sleep. At individual sleep component level, associations were most evident for sleep quality and daytime sleepiness. Several associations between inflammation-related exposures and individual sleep components differed in direction and strength between women with overweight or obesity.
CONCLUSIONS: Associations between inflammation and sleep during pregnancy were heterogeneous across inflammation-related exposures, sleep components, and BMI status. These findings support a multidomain inflammatory framework for understanding multidimensional sleep health during pregnancy.