Maternal early pregnancy body mass index and risk of insomnia in the offspring

Mia Q Zhu; Sven Cnattingius; Louise M O'Brien; Eduardo Villamor

doi:10.1093/sleep/zsae236

Maternal early pregnancy body mass index and risk of insomnia in the offspring

Sleep. 2024 Oct 7:zsae236. doi: 10.1093/sleep/zsae236. Online ahead of print.

Authors

Mia Q Zhu¹, Sven Cnattingius², Louise M O'Brien³, Eduardo Villamor¹

Affiliations

¹ Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States.
² Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
³ Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, United States.

PMID: 39373215
DOI: 10.1093/sleep/zsae236

Abstract

Study objectives: To investigate the association between maternal early pregnancy body mass index (BMI) and risk of offspring insomnia.

Methods: We conducted a nationwide cohort study among 3,281,803 singleton live births in Sweden born 1983-2015. Using national registries with prospectively recorded information, we followed participants for an insomnia diagnosis from 2 to up to 35 years of age. We compared insomnia risks by early pregnancy BMI categories using hazard ratios (HR) with 95% confidence intervals (CI) from adjusted Cox models. To assess unmeasured shared familial confounding, we conducted sibling-controlled analyses among 1,724,473 full siblings and studied the relation of maternal full sisters' BMI and insomnia risk in 1,185,998 offspring.

Results: There were 7,154 insomnia diagnoses over a median follow-up age of 17.9 years. Compared with women with normal BMI, adjusted HR (95% CI) of offspring insomnia for early pregnancy BMI categories overweight, obesity class I, and obesity classes II or III were, respectively, 1.22 (1.14, 1.30), 1.60 (1.45, 1.77), and 2.11 (1.83, 2.45). Corresponding adjusted HR (95% CI) in sibling comparisons were, respectively, 1.32 (1.05, 1.65), 1.48 (1.03, 2.14), and 1.56 (0.91, 2.65). Associations with maternal sisters' BMI were attenuated, suggesting a weak role for unmeasured shared factors. Other pregnancy, birth, and neonatal complications were associated with risk of insomnia in offspring but did not substantially mediate the association.

Conclusions: The dose-response relation between maternal overweight and obesity severity with offspring insomnia risk is not fully explained by shared familial factors.

Keywords: Insomnia; maternal body mass index; maternal obesity; maternal overweight; obesity.

© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.