{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:23:26Z","timestamp":1787016206427,"version":"build-2736575974"},"reference-count":69,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T00:00:00Z","timestamp":1644796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1065854"],"award-info":[{"award-number":["1065854"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015988","name":"Norman Beischer Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015988","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      In Australia, a significant proportion of stillbirths remain unexplained. Recent research has highlighted nocturnal maternal behaviours as potentially modifiable contributors. This study determined whether sleep\u2010related behaviours including sleep position and sleep\u2010disordered breathing adversely affect fetuses overnight, in both uncomplicated pregnancies and those at increased risk due to hypertensive disorders or fetal growth restriction (FGR). All participants underwent polysomnography with time\u2010synchronized fetal heart rate (FHR) monitoring (cardiotocography \u2013 CTG) in late pregnancy. CTGs were analysed for abnormal FHR events, including decelerations and reduced variability, by two blinded observers and exported into the sleep study to temporally align FHR events with sleep behaviours. For each FHR event, 10 control epochs with normal FHR were randomly selected for the same participant. Conditional logistic regression assessed the relationships between FHR events and sleep behaviours. From 116 participants, 52 had a total of 129 FHR events overnight; namely prolonged decelerations and prolonged periods of reduced variability. Significantly more FHR events were observed in women with FGR and\/or a hypertensive disorder compared with uncomplicated pregnancies (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.006). FHR events were twice as likely to be preceded by a change in body position within the previous 5\u00a0min, compared with control epochs (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.007), particularly in hypertensive pregnancies both with and without FGR. Overall, FHR events were not temporally related to supine body position, respiratory events or snoring. Our results indicate that most fetuses tolerate sleep\u2010related stressors, but further research is needed to identify the interplay of maternal and fetal conditions putting the fetus at risk overnight.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Maternal sleep behaviours including supine position and sleep\u2010disordered breathing are potential contributors to stillbirth but much of this work is based on self\u2010reported data.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Using time\u2010synchronized polysomnography and cardiotocography, we found that nocturnal fetal heart rate decelerations were more likely to be preceded by a change in body position compared with epochs containing normal fetal heart rate, particularly in hypertensive pregnancies with or without fetal growth restriction.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>There was no temporal relationship between maternal sleeping position, snoring or apnoeic events and an abnormal fetal heart rate overnight.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>We conclude that most fetuses can tolerate sleep\u2010related stressors with no evidence of fetal heart rate changes indicating compromised wellbeing.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Further work needs to identify how sleep behaviours contribute to stillbirth risk and how these intersect with underlying maternal and fetal conditions.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1113\/jp282528","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T21:27:50Z","timestamp":1642714070000},"page":"1791-1806","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Maternal sleep behaviours preceding fetal heart rate events on cardiotocography"],"prefix":"10.1113","volume":"600","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6754-7359","authenticated-orcid":false,"given":"Danielle L.","family":"Wilson","sequence":"first","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health  Heidelberg Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Parkville Victoria 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