{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:27:04Z","timestamp":1790699224088,"version":"4.1.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010284","name":"Herman and Gwendolyn Shapiro Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010284","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007856","name":"Baylor College of Medicine","doi-asserted-by":"publisher","award":["Ob\/Gyn Resident Research Funds"],"award-info":[{"award-number":["Ob\/Gyn Resident Research Funds"]}],"id":[{"id":"10.13039\/100007856","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008028","name":"School of Medicine and Public Health, University of Wisconsin-Madison","doi-asserted-by":"publisher","award":["Department of Obstetrics and Gynecology"],"award-info":[{"award-number":["Department of Obstetrics and Gynecology"]}],"id":[{"id":"10.13039\/100008028","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008028","name":"School of Medicine and Public Health, University of Wisconsin-Madison","doi-asserted-by":"publisher","award":["Department of Neurology"],"award-info":[{"award-number":["Department of Neurology"]}],"id":[{"id":"10.13039\/100008028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Shift work has been associated with adverse pregnancy outcomes. The objective of this study was to evaluate the association between sleep disturbances and adverse pregnancy outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and findings<\/jats:title>\n<jats:p>This was a secondary analysis of a prospective study of participants enrolled in a prospective observational study wherein gravidae were screened for sleep apnea (2010\u20132012). A screening questionnaire with standard sleep apnea questionnaires as well as novel items about shift work and nocturnal sleep duration was administered at a prenatal care visit. Short sleep duration was defined as less than 7 hours. Prolonged sleep duration was defined as greater than 9 hours.<\/jats:p>\n<jats:p>In a cohort of 1125 pregnant people, 9.4% reported shift work at the time of screening. Gravidae who reported shift work were more likely than gravidae who reported no shift work to develop preeclampsia (28.3% versus 13.0%, P&lt;0.001), preeclamspsia with severe features (16.0% versus 8.5%, P = 0.010), gestational diabetes (28.3% versus 19.9%, P = 0.041), and a composite of adverse obstetric outcomes (61.3% versus 47.8%, P = 0.008). After adjusting for potentially confounding variables, shift work was associated with an increased risk for preeclampsia with (adjusted relative risk (aRR) 1.70, 95% CI 1.03\u20132.79, p = 0.036) and without (aRR 2.03, 95% CI 1.43\u20132.90, p&lt;0.001) severe features, and gestational diabetes mellitus class A1 (aRR 1.47, 95% CI 1.05\u20132.05, p = 0.023) and class A2 (aRR 1.67, 95% CI 1.13\u20132.44, p = 0.009). Sleep duration was associated with gestational diabetes (31.3% among those with short sleep duration, 25.2% among those with normal sleep duration and 14.0% among those with prolonged sleep duration, P&lt;0.001) and gestational diabetes class A2 (29.5%, 17.9%, and 10.1%, respectively, P&lt;0.001). Gravidae with prolonged sleep duration experienced less composite adverse pregnancy outcomes at 42.6% compared to 57.4% for those with short sleep duration or 52.5% for those with normal sleep duration, P = 0.002.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Shift work and sleep duration are both associated with adverse pregnancy outcomes. Further research on the impact of sleep disturbance on pregnancy outcomes is warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0272218","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T17:40:29Z","timestamp":1659634829000},"page":"e0272218","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Shift work and sleep duration are associated with adverse pregnancy outcomes in a predominantly Latinx population with high rates of obesity"],"prefix":"10.1371","volume":"17","author":[{"given":"Jeannette M.","family":"Larson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela H.","family":"Bazalakova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8681-7385","authenticated-orcid":true,"given":"Amy","family":"Godecker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"DelBeccaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjersti M.","family":"Aagaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3537-8030","authenticated-orcid":true,"given":"Kathleen M.","family":"Antony","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"pone.0272218.ref001","first-page":"561","article-title":"Protein synthesis, bodily renewal and the sleep-wake cycle","volume-title":"Clinical Science.","author":"K Adam","year":"1983"},{"key":"pone.0272218.ref002","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1055\/s-0037-1608843","article-title":"Sleep Disorders in Pregnancy","volume":"37","author":"M. Bazalakova","year":"2017","journal-title":"Semin Neurol"},{"key":"pone.0272218.ref003","volume-title":"Obstetrics: Normal and Problem Pregnancies","author":"KM Antony","year":"2021","edition":"8"},{"key":"pone.0272218.ref004","first-page":"221","article-title":"The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis","author":"C Cai","year":"2019","journal-title":"Am J Obstet Gynecol."},{"key":"pone.0272218.ref005","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1111\/j.1471-0528.2011.03066.x","article-title":"Shift work and pregnancy outcomes: A systematic review with meta-analysis of currently available epidemiological studies.","author":"M Bonzini","year":"2011","journal-title":"BJOG: An International Journal of Obstetrics and Gynaecology. BJOG"},{"key":"pone.0272218.ref006","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1136\/oem.51.7.470","article-title":"Association of rotating shiftwork with preterm births and low birth weight among never smoking women textile workers in China.","volume":"51","author":"X Xu","year":"1994","journal-title":"Occup Environ Med"},{"key":"pone.0272218.ref007","first-page":"15","article-title":"Associations between symptoms of sleep-disordered breathing and maternal sleep patterns with late stillbirth: Findings from an individual participant data meta-analysis","author":"RS Cronin","year":"2020","journal-title":"PLoS One"},{"key":"pone.0272218.ref008","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.sleep.2018.07.021","article-title":"Association between sleep duration during pregnancy and gestational diabetes mellitus: a meta-analysis","volume":"52","author":"YH Xu","year":"2018","journal-title":"Sleep Med"},{"key":"pone.0272218.ref009","first-page":"101436","article-title":"Sleep disturbances during pregnancy and adverse maternal and fetal outcomes: A systematic review and meta-analysis.","volume-title":"Sleep Medicine Reviews.","author":"Q Lu","year":"2021"},{"key":"pone.0272218.ref010","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.smrv.2009.05.001","article-title":"Sleep deprivation during pregnancy and maternal and fetal outcomes: Is there a relationship?","volume":"14","author":"JJ Chang","year":"2010","journal-title":"Sleep Med Rev"},{"key":"pone.0272218.ref011","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1038\/jp.2014.25","article-title":"Association of adverse perinatal outcomes with screening measures of obstructive sleep apnea","volume":"34","author":"KM Antony","year":"2014","journal-title":"J Perinatol"},{"key":"pone.0272218.ref012","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1038\/jp.2014.48","article-title":"Obstructive sleep apnea in pregnancy: reliability of prevalence and prediction estimates.","volume":"34","author":"KM Antony","year":"2014","journal-title":"J Perinatol"},{"key":"pone.0272218.ref013","article-title":"What is Shift Work.","author":"D Pacheco","year":"2022","journal-title":"Sleep Foundation: A OneCare Media Company [Internet]"},{"key":"pone.0272218.ref014","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1093\/sleep\/33.5.585","article-title":"Sleep duration and all-cause mortality: A systematic review and meta-analysis of prospective studies.","volume":"33","author":"FP Cappuccio","year":"2010","journal-title":"Sleep"},{"key":"pone.0272218.ref015","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1093\/eurheartj\/ehr007","article-title":"Sleep duration predicts cardiovascular outcomes: A systematic review and meta-analysis of prospective studies","volume":"32","author":"FP Cappuccio","year":"2011","journal-title":"Eur Heart J"},{"key":"pone.0272218.ref016","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.cub.2019.01.069","article-title":"Ad libitum Weekend Recovery Sleep Fails to Prevent Metabolic Dysregulation during a Repeating Pattern of Insufficient Sleep and Weekend Recovery Sleep","volume":"29","author":"CM Depner","year":"2019","journal-title":"Curr Biol"},{"key":"pone.0272218.ref017","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.sleep.2010.12.012","article-title":"Short sleep in young adults: Insomnia or sleep debt? Prevalence and clinical description of short sleep in a representative sample of 1004 young adults from France","volume":"12","author":"D L\u00e9ger","year":"2011","journal-title":"Sleep Med"},{"key":"pone.0272218.ref018","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/j.cub.2012.03.038","article-title":"Social Jetlag and Obesity.","volume":"22","author":"T Roenneberg","year":"2012","journal-title":"Curr Biol"},{"key":"pone.0272218.ref019","first-page":"159","article-title":"Diagnosis and management of preeclampsia and eclampsia.","volume":"99","author":"American College of Obstetricians and Gynecologists","year":"2002","journal-title":"ACOG Practice Bulletin No.33. Obstet Gynecol."},{"key":"pone.0272218.ref020","article-title":"Gestational Diabetes: ACOG Practice Bulletin No. 30","author":"American College of Obstetricians and Gynecologists","year":"2001","journal-title":"Obstet Gynecol"},{"key":"pone.0272218.ref021","first-page":"329","volume-title":"Comprehensive Gynecology","author":"S Keyhan","year":"2017"},{"key":"pone.0272218.ref022","first-page":"709","article-title":"ACOG Practice Bulletin. No. 31. Clinical management guidelines for obstetrician-gynecologists","volume":"98","author":"Assessment of risk factors for preterm birth","year":"2001","journal-title":"Obstet Gynecol"},{"key":"pone.0272218.ref023","first-page":"66","volume-title":"Infectious Diseases in Obstetrics and Gynecology: A systematic approach to management Critique","author":"DE Soper","year":"2009"},{"key":"pone.0272218.ref024","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1111\/1471-0528.14694","article-title":"Core outcome sets in women\u2019s and newborn health: a systematic review","volume":"124","author":"JMN Duffy","year":"2017","journal-title":"BJOG An Int J Obstet Gynaecol"},{"key":"pone.0272218.ref025","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1097\/AOG.0000000000003607","article-title":"Macrosomia: ACOG Practice Bulletin Summary, Number 216","volume":"135","year":"2020","journal-title":"Obstet Gynecol"},{"key":"pone.0272218.ref026","doi-asserted-by":"crossref","first-page":"e97","DOI":"10.1097\/AOG.0000000000003070","article-title":"ACOG Practice Bulletin No. 204: Fetal Growth Restriction.","volume":"133","year":"2019","journal-title":"Obstet Gynecol"},{"key":"pone.0272218.ref027","author":"Published by World Health Organization","year":"2015"},{"key":"pone.0272218.ref028","author":"World Health Organization","year":"2000"},{"key":"pone.0272218.ref029","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A Modified Poisson Regression Approach to Prospective Studies with Binary Data","volume":"159","author":"G. Zou","year":"2004","journal-title":"Am J Epidemiol"},{"key":"pone.0272218.ref030","first-page":"163","article-title":"The metabolic consequences of sleep deprivation.","volume-title":"Sleep Medicine Reviews.","author":"KL Knutson","year":"2007"},{"key":"pone.0272218.ref031","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1001\/archinte.163.2.205","article-title":"A prospective study of sleep duration and coronary heart disease in women","volume":"163","author":"NT Ayas","year":"2003","journal-title":"Arch Intern Med"},{"key":"pone.0272218.ref032","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1161\/HYPERTENSIONAHA.113.02664","article-title":"Strategy for standardization of preeclampsia research study design","volume":"63","author":"L Myatt","year":"2014","journal-title":"Hypertension"},{"key":"pone.0272218.ref033","first-page":"84","article-title":"Shift Work Effects and Pregnancy Outcome: A Historical Cohort Study.","volume":"12","author":"MH Davari","year":"2018","journal-title":"J Fam Reprod Heal"},{"key":"pone.0272218.ref034","article-title":"Biological rhythms and preeclampsia","author":"AJ Ditisheim","year":"2013","journal-title":"Frontiers in Endocrinology. Frontiers Media SA"},{"key":"pone.0272218.ref035","doi-asserted-by":"crossref","first-page":"3552","DOI":"10.1210\/en.2011-0081","article-title":"Circadian variation in placental and hepatic clock genes in rat pregnancy","volume":"152","author":"MD Wharfe","year":"2011","journal-title":"Endocrinology"},{"key":"pone.0272218.ref036","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1071\/RD09243","article-title":"Clock gene expression in gravid uterus and extra-embryonic tissues during late gestation in the mouse","volume":"22","author":"CK Ratajczak","year":"2010","journal-title":"Reprod Fertil Dev"},{"key":"pone.0272218.ref037","doi-asserted-by":"crossref","first-page":"e0215748","DOI":"10.1371\/journal.pone.0215748","article-title":"Night work during pregnancy and preterm birth\u2014A large register-based cohort study","volume":"14","author":"IO Specht","year":"2019","journal-title":"PLoS One"},{"key":"pone.0272218.ref038","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s00420-014-0934-9","article-title":"Shift work, long working hours and preterm birth: a systematic review and meta-analysis.","volume":"87","author":"MJGJ van Melick","year":"2014","journal-title":"Int Arch Occup Environ Health"},{"key":"pone.0272218.ref039","unstructured":"Houston. In: Wikipedia [Internet]. 2022. Available: https:\/\/en.wikipedia.org\/wiki\/Houston#Race_and_ethnicity."},{"key":"pone.0272218.ref040","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1038\/jp.2016.130","article-title":"Generation and validation of a universal perinatal database and biospecimen repository: PeriBank.","volume":"36","author":"KM Antony","year":"2016","journal-title":"J Perinatol"},{"key":"pone.0272218.ref041","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1097\/AOG.0000000000002501","article-title":"The American College of Obstetricians and Gynecologists. Gestational diabetes mellitus. ACOG Practice Bulletin No. 190","volume":"131","year":"2018","journal-title":"Obstet Gynecol"},{"key":"pone.0272218.ref042","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1365-3016.2011.01222.x","article-title":"Maternal ethnicity and pre-eclampsia in New York City, 1995\u20132003","volume":"26","author":"J Gong","year":"2012","journal-title":"Paediatr Perinat Epidemiol"},{"key":"pone.0272218.ref043","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1136\/oemed-2012-101032","article-title":"Work activities and risk of prematurity, low birth weight and pre-eclampsia: an updated review with meta-analysis.","volume":"70","author":"KT Palmer","year":"2013","journal-title":"Occup Environ Med"},{"key":"pone.0272218.ref044","first-page":"12","article-title":"Short-term sleep deprivation leads to decreased systemic redox metabolites and altered epigenetic status.","author":"MS Trivedi","year":"2017","journal-title":"PLoS One"},{"key":"pone.0272218.ref045","first-page":"165354","article-title":"Oxidative stress: Normal pregnancy versus preeclampsia.","volume-title":"Biochimica et Biophysica Acta\u2014Molecular Basis of Disease","author":"DI Chiarello","year":"2020"},{"key":"pone.0272218.ref046","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1034\/j.1600-079x.2001.310212.x","article-title":"Melatonin protects against oxidative mitochondrial damage induced in rat placenta by ischemia and reperfusion","volume":"31","author":"Y Okatani","year":"2001","journal-title":"J Pineal Res"},{"key":"pone.0272218.ref047","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1093\/humupd\/dmt054","article-title":"Melatonin and stable circadian rhythms optimize maternal, placental and fetal physiology","volume":"20","author":"RJ Reiter","year":"2014","journal-title":"Hum Reprod Update"},{"key":"pone.0272218.ref048","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.biopsych.2015.05.014","article-title":"Sleep disturbance, sleep duration, and inflammation: A systematic review and meta-analysis of cohort studies and experimental sleep deprivation","volume":"80","author":"MR Irwin","year":"2016","journal-title":"Biol Psychiatry"},{"key":"pone.0272218.ref049","first-page":"275","article-title":"Pre-eclampsia: pathogenesis, novel diagnostics and therapies","volume-title":"Nature Reviews Nephrology.","author":"EA Phipps","year":"2019"},{"key":"pone.0272218.ref050","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/8238727","article-title":"Cross-Talk between Oxidative Stress and Inflammation in Preeclampsia.","volume-title":"Oxidative Medicine and Cellular Longevity","author":"MB Ten\u00f3rio","year":"2019"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0272218","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T17:41:16Z","timestamp":1659634876000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0272218"}},"subtitle":[],"editor":[{"given":"Henrik","family":"Oster","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,8,4]]},"references-count":50,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0272218","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,4]]}}}