{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:55:55Z","timestamp":1787702155883,"version":"build-2784847793"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Insomnia and obstructive sleep apnea (OSA) are associated with pregnancy complications.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the association of insomnia and OSA during pregnancy with the risk of ischemic placental disease (IPD) and severe morbidity (SM) and to compare these risks between the 2 sleep disorders.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional study included a statewide population-based sample of liveborn singleton births with linked birth certificates for birthing people and their infants in California from January 1, 2011, through December 31, 2020. The analysis was performed on July 22, 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Insomnia and OSA.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcomes were IPD, defined as preeclampsia, placental abruption, and birth of a neonate small for gestational age (SGA), and SM, defined according to the Centers for Disease Control and Prevention definition.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n During the study period, there were 4\u202f145\u202f096 singleton live births among birthing people aged 13 to 55 years; 4783 (0.1%) had insomnia, 5642 (0.1%) had OSA, and 4 134 671 (99.7%) had neither condition. The prevalence of insomnia and OSA was 116 and 136 cases per 1000 live births, respectively. Compared with patients without insomnia or OSA (738\u202f660 [17.9%]), the adjusted relative risk (ARR) of any IPD was 1.42 (95% CI, 1.35-1.50) for those with insomnia (1406 patients [29.4%]) and 1.57 (95% CI, 1.50-1.64) for those with OSA (1848 [32.8%]). Compared with patients with neither disorder, the ARR of birth of an SGA neonate was higher for those with insomnia (1.23; 95% CI, 1.13-1.35) than for those with OSA. The ARR of preterm birth was 1.81 (95% CI, 1.68-1.95) for insomnia (711 patients [14.9%]) and 1.73 (95% CI, 1.62-1.85) for OSA (870 [15.4%]) vs neither disorder (279\u202f364 [6.8%]). The ARR of SM was 2.26 (95% CI, 2.03-2.50) for insomnia (366 patients [7.7%]) and 2.81 (95% CI, 2.58-3.06) for OSA (545 [9.7%]) vs neither disorder (93\u202f857 [2.3%]).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cross-sectional study of singleton live births, pregnant individuals with insomnia or OSA were at increased risk for IPD, SM, and preterm birth compared with those without these sleep disorders. Further study is needed to determine the biological mechanisms for these risks and whether early identification and targeted preventive interventions may improve pregnancy outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.32189","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T15:00:24Z","timestamp":1758034824000},"page":"e2532189","source":"Crossref","is-referenced-by-count":4,"title":["Ischemic Placental Disease and Severe Morbidity in Pregnant Patients With Sleep Disorders"],"prefix":"10.1001","volume":"8","author":[{"given":"Naima","family":"Ross","sequence":"first","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, New York"},{"name":"NYU Langone Health, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Baer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California San Diego, La Jolla"},{"name":"The California Preterm Birth Initiative, University of California San Francisco"},{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott P.","family":"Oltman","sequence":"additional","affiliation":[{"name":"The California Preterm Birth Initiative, University of California San Francisco"},{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco"},{"name":"Department of Biostatistics and Epidemiology, University of California San Francisco School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana R.","family":"Gossett","sequence":"additional","affiliation":[{"name":"NYU Langone Health, New York"},{"name":"Institute of Global Health Sciences, University of California San Francisco School of Medicine"},{"name":"Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Nisha","family":"Aurora","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYU Langone Health, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Jelliffe-Pawlowski","sequence":"additional","affiliation":[{"name":"The California Preterm Birth Initiative, University of California San Francisco"},{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco"},{"name":"Department of Biostatistics and Epidemiology, University of California San Francisco School of Medicine"},{"name":"Rory Meyers College of Nursing, NYU, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S.","family":"Brandt","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, New York"},{"name":"NYU Langone Health, New 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