BackgroundThe Auckland Stillbirth study demonstrated a two-fold increased risk of late stillbirth for women who did not go to sleep on their left side. Two further studies have confirmed an increased risk of late stillbirth with supine sleep position. As sleep position is modifiable, we surveyed self-reported late pregnancy sleep position, knowledge about sleep position, and views about changing going-to-sleep position.MethodsParticipants in this 2014 survey were pregnant women (n = 377) in their third trimester from South Auckland, New Zealand, a multi-ethnic and predominantly low socio-economic population. An ethnically-representative sample was obtained using random sampling. Multivariable logistic regression was performed to identify factors independently associated with non-left sided going-to-sleep position in late pregnancy.ResultsRespondents were 28 to 42 weeks’ gestation. Reported going-to-sleep position in the last week was left side (30%), right side (22%), supine (3%), either side (39%) and other (6%). Two thirds (68%) reported they had received advice about sleep position. Non-left sleepers were asked if they would be able to change to their left side if it was better for their baby; 87% reported they would have little or no difficulty changing. Women who reported a non-left going-to-sleep position were more likely to be of Maori (aOR 2.64 95% CI 1.23–5.66) or Pacific (aOR 2.91 95% CI 1.46–5.78) ethnicity; had a lower body mass index (BMI) (aOR 0.93 95% CI 0.89–0.96); and were less likely to sleep on the left-hand side of the bed (aOR 3.29 95% CI 2.03–5.32).ConclusionsMaternal going-to-sleep position in the last week was side-lying in 91% of participants. The majority had received advice to sleep on their side or avoid supine sleep position. Sleeping on the left-hand side of the bed was associated with going-to-sleep on the left side. Most non-left sleepers reported their sleeping position could be modified to the left side suggesting a public health intervention about sleep position is likely to be feasible in other multi-ethnic communities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-017-1378-5) contains supplementary material, which is available to authorized users.
Pasifika Medical Association Conference 2019: The Rising Tide Statement, 26 September 2019
Purpose This survey investigated late pregnancy maternal sleep practices and ability to modify sleep position in order to generate information on which to base future public health messages about optimal going‐to‐sleep position. Research Question What are the sleep practices of women in late pregnancy, and what are their views about changing going‐to‐sleep position if this was recommended? Significance Maternal sleep position in late pregnancy is a modifiable risk factor for late stillbirth. A 2011 study from Auckland, New Zealand, was the first to demonstrate a 2‐fold increased risk for women who did not go to sleep on their left side the night before the fetus was thought to have died, with the highest risk for women who settled to sleep supine. This association has since been confirmed by an Australian and Ghanaian study and a New Zealand multicentre study. Methods A random sample of ethnically‐representative women (N = 377), between 28 and 42 weeks’ gestation, were surveyed in 2014 in South Auckland, New Zealand, a multicultural and socioeconomically disadvantaged population with an increased risk of stillbirth. Factors independently associated with non‐left side going‐to‐sleep position in late pregnancy were identified using multivariable logistic regression. Results Self‐reported going‐to‐sleep position in the last week was left (30%), right (22%), supine (3%), either side (39%), and other (6%). The majority (68%) had received advice about pregnancy sleep position. A non‐left position was more likely to be reported by women of Maori (adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.23‐5.66) or Pacific (aOR, 2.91; 95% CI, 1.46‐5.78) ethnicity, and those who did not sleep on the left‐hand side of the bed (aOR, 3.29; 95% CI, 2.03‐5.32). Most (87%) non‐left sleepers reported that they would have minimal difficulty changing to going to sleep on their left side in late pregnancy if this was better for their fetus. Discussion The results from this survey suggest that going‐to‐sleep position in late pregnancy is likely to be readily modifiable. This suggests that a public health intervention, about the importance of optimal late pregnancy going‐to‐sleep position to optimise fetal well‐being, is likely to be feasible in similar communities with an increased risk of stillbirth.
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