Circadian rhythm and its association with birth and infant outcomes: research protocol of a prospective cohort study

Abstract

Background: Circadian rhythm plays an important role as our internal body's clock that synchronizes behavior and physiology according to the external 24-h light-dark cycle. Past studies have associated disrupted circadian rhythm with higher risk of miscarriages, preterm birth and low birth weights. This paper described the protocol of a prospective cohort study which aims to determine the circadian rhythm in pregnant women, identify its association with maternal factors during pregnancy, gestational weight gain, birth and infant outcomes. Methods: Ten government maternal and child health clinics in Kuala Lumpur, Malaysia will be randomly selected. Sample size of 438 first-trimester pregnant women will be followed-up until the birth of their infant. Salivary melatonin and cortisol concentration among subsample will be determined using enzyme-linked immunosorbent assay. Data on sleep quality, psychological distress and morningness/eveningness chronotype of pregnant women will be collected using validated questionnaires. Pedometer will be used to measure 5-day physical activity data. Total gestational weight gain will be determined at the end of pregnancy. Utilization of 3-day food record is to capture meal timing and nutrient intake. All measurements will be done in 2nd and 3rd trimester. Birth outcomes will be collected through clinic records and Centers for Disease Control and Prevention (CDC) Neonatal questionnaire. Infants will be followed-up at 6 and 12 months old to obtain anthropometric measurements. Discussion: There is a growing recognition of the role of maternal circadian rhythm, which entrains fetal circadian rhythms that may subsequently have long-term health consequences. The present study will identify the effect of circadian rhythm on pregnancy outcomes and infant growth in the first year of life.

Melatonin’s Impact on Antioxidative and Anti-Inflammatory Reprogramming in Homeostasis and Disease

“…Disturbances in the fetal circadian system may trigger long-term consequences. Interference to normal light/dark cycle in late pregnancy or during the perinatal period may have detrimental effects on the behavior and metabolic functions of the offspring, possibly contributing to conditions such as metabolic syndrome, obesity, attention deficit-hyperactivity disorder, or autism spectrum disorders [ 81 , 82 , 83 , 84 ].…”

Gestational sleep deprivation is associated with higher offspring body mass index and blood pressure

“…childhood lifestyle and sleep) could exist during gestation and early life which may warrant further study. There is one published research protocol of a prospective cohort study that investigates the effects of circadian rhythm on birth and infant outcomes, which can replicate the studied associations [ 56 ].…”

Chronodisruption: effects on reproduction, transgenerational health of offspring and epigenome

“…On the other hand, maternal-fetal circadian communication and how signals during pregnancy can synchronize daily rhythms between the mother and the fetus is also critical for clinical problems such as preterm birth (Bates & Herzog 2020). Recently, a protocol of a prospective cohort study to determine the role of circadian rhythm in pregnant women and to identify pregnancy indices such as gestational weight gain with birth and infant outcomes was described (Kaur et al 2020). These results will provide much needed information on the effects of the circadian rhythm during pregnancy and its consequences on the fetal and the first year of life of the infant's growth.…”