RESUMO
BACKGROUND: Sleep disorders are thought to be common in women with in vitro fertilization and embryo transfer (IVF-ET) conception. Although a few studies have investigated the association between maternal sleep quality and infant birth weight, it is unclear to what extent birth weight is associated with sleep quality during pregnancy among these women. Therefore, we conducted a cohort study to assess sleep quality among women receiving IVF-ET during the subsequent pregnancy and investigated the association of self-report sleep quality on infant birth weight. METHODS: This study was a prospective cohort study recruiting women who were to receive assisted reproductive technology (ART). Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) before oocyte retrieval and in the first trimester, second trimester, and third trimester during pregnancy. A generalized estimating equation (GEE) model was applied to evaluate the associations between sleep quality at specific times and infant birth weight. A general linear model was conducted to explore which component of the PSQI questionnaire was most associated with infant birth weight. RESULTS: Between August 2016 and August 2020, a total of 1344 women who had singleton births with IVF conception were included in the analysis. PSQI scores in the first trimester were highest (4.59 ± 2.47) but had no significant relationship with birth weight. After accounting for potential influencing factors, we found that poor maternal sleep quality in the second trimester was significantly associated with small for gestational age (SGA) among female infants (OR = 3.03, 95% CI = 1.04 to 9.71, P = 0.044), while no association was observed between sleep quality and birth weight in male infants (OR = 1.64, 95% CI = 0.68 to 3.99, P = 0.271). CONCLUSIONS: These findings suggest that the sleep quality of women with IVF pregnancies may influence fetal weight in a trimester- and sex-specific manner.
Assuntos
Qualidade do Sono , Injeções de Esperma Intracitoplásmicas , Gravidez , Masculino , Feminino , Humanos , Peso ao Nascer , Estudos de Coortes , Estudos Prospectivos , Sêmen , Fertilização in vitro , Técnicas de Reprodução Assistida , Estudos Retrospectivos , EspermatozoidesRESUMO
The purpose of this study is to provide evidence for better guidance related to bed rest after intrauterine insemination (IUI). We conducted a randomized trial to compare the effect of 15 min versus 30 min of bed rest after IUI on pregnancy rate. A total of 204 couples were recruited from May 2021 to December 2021 and randomized to remain in the supine position for either 15 or 30 min after the procedure. The outcomes were the clinical pregnancy rate and comfort level after IUI. Ultimately, 198 couples were included in the analysis. The 15-min immobilization group consisted of 100 couples (226 cycles), and the 30-min immobilization group consisted of 98 couples (225 cycles). The clinical pregnancy rate per couple in the 15-min immobilization group (26 of 100) was not different from that in the 30-min immobilization group (23 of 98). With the use of discrete-time survival analysis, the cumulative probability of clinical pregnancy also showed no difference between these two groups. Based on the literature and on our study, the possible beneficial effect of 30-min immobilization after IUI is at least questionable, and a shorter time could be implemented depending on the results of a systematic review and the individual patient data from the currently executed trials.