{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:07:50Z","timestamp":1791216470116,"version":"4.1.0"},"reference-count":52,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,8,19]]},"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore associations between features of sleep during pregnancy and adverse outcomes for the infant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>E Moe, M\u0101m\u0101 is a cohort study in Aotearoa\/New Zealand that investigates self-reported sleep and maternal health in late pregnancy and the postpartum period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Women (N=633; 194 M\u0101ori) reported detailed information on their sleep duration, quality, disturbances, disorders (snoring, breathing pauses, twitching legs, restless legs) and daytime sleepiness between 35 and 37\u2005weeks gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Birthweight and fetal distress during labour were extracted from medical records. Associations between each sleep variable and small or large for gestational age (SGA\/LGA) using customised birthweight centile or fetal distress were estimated using multinomial\/logistic regression, controlling for potential confounders. Secondary analyses considered differences in associations between M\u0101ori and non-M\u0101ori women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was some indication that breathing pauses (a measure of sleep apnoea) were associated with both SGA (OR 2.8, 95% CI 0.9 to 9.0, p=0.08) and LGA (OR 2.0, 95% CI 0.7 to 5.7, p=0.20), with the association for LGA being stronger when only pregnancy-onset breathing pauses were considered (OR 3.5, 95% CI 1.3 to 9.6, p=0.01). There was also some evidence that pregnancy-onset leg twitching (OR 3.3, 95% CI 1.1 to 10.0, p=0.03) and frequent sleep disturbance due to feeling too hot or too cold (OR 1.7, 95% CI 0.9 to 3.6, p=0.13) were associated with higher risk of fetal distress. Other sleep measures, including snoring, were not associated with SGA, LGA or fetal distress. Many of the associations we observed were considerably stronger in M\u0101ori compared with non-M\u0101ori women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We did not find evidence of previously reported associations between snoring and SGA. Our findings tentatively suggest that self-reported breathing pauses and leg twitching in late pregnancy are associated with infant outcomes, and highlight ethnic inequalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-008910","type":"journal-article","created":{"date-parts":[[2015,10,5]],"date-time":"2015-10-05T22:18:40Z","timestamp":1444083520000},"page":"e008910","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Self-reported sleep in late pregnancy in relation to birth size and fetal distress: the E Moe, M\u0101m\u0101 prospective cohort study"],"prefix":"10.1136","volume":"5","author":[{"given":"Laura D","family":"Howe","sequence":"first","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol, UK"},{"name":"Sleep-Wake Research Centre, Massey University, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T Leigh","family":"Signal","sequence":"additional","affiliation":[{"name":"Sleep-Wake Research Centre, Massey University, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah-Jane","family":"Paine","sequence":"additional","affiliation":[{"name":"Sleep-Wake Research Centre, Massey University, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronwyn","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Sleep-Wake Research Centre, Massey University, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Priston","sequence":"additional","affiliation":[{"name":"Sleep-Wake Research Centre, Massey University, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Muller","sequence":"additional","affiliation":[{"name":"Sleep-Wake Research Centre, Massey University, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Lee","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Huthwaite","sequence":"additional","affiliation":[{"name":"University of Otago, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippa","family":"Gander","sequence":"additional","affiliation":[{"name":"Sleep-Wake Research Centre, Massey University, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,10,5]]},"reference":[{"key":"2025121509473607000_5.10.e008910.1","doi-asserted-by":"crossref","first-page":"e76615","DOI":"10.1371\/journal.pone.0076615","article-title":"Preterm birth, age at school entry and educational performance","volume":"8","author":"Odd","year":"2013","journal-title":"PLoS ONE"},{"key":"2025121509473607000_5.10.e008910.2","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1111\/apa.12320","article-title":"Movement outcomes of infants born moderate and late preterm","volume":"102","author":"Odd","year":"2013","journal-title":"Acta Paediatr"},{"key":"2025121509473607000_5.10.e008910.3","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291708005126"},{"key":"2025121509473607000_5.10.e008910.4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000348382","article-title":"The epidemiology of low birthweight","volume":"74","author":"Kramer","year":"2013","journal-title":"Nestle Nutr Inst Workshop Ser"},{"key":"2025121509473607000_5.10.e008910.5","doi-asserted-by":"crossref","first-page":"e70917","DOI":"10.1371\/journal.pone.0070917","article-title":"Clinical prediction in early pregnancy of infants small for gestational age by customised birthweight centiles: findings from a healthy nulliparous cohort","volume":"8","author":"McCowan","year":"2013","journal-title":"PLoS ONE"},{"key":"2025121509473607000_5.10.e008910.6","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0b013e318195160e"},{"key":"2025121509473607000_5.10.e008910.7","doi-asserted-by":"publisher","DOI":"10.1177\/10547739922158377"},{"key":"2025121509473607000_5.10.e008910.8","doi-asserted-by":"crossref","unstructured":"Lee KA . 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