Evidence map›Paper›PMID 34019675›Full record

ArticleSleep2021

Maternal depressive symptoms, sleep, and odds of spontaneous early birth: implications for racial inequities in birth outcomes.

Lisa M Christian, Shannon Webber, Shannon Gillespie, Anna M Strahm, Jonathan Schaffir, Yevgeniya Gokun, Kyle Porter

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Sleep, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lisa M ChristianDepartment of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Shannon WebberCollege of Medicine, The Ohio State University, Columbus, OH, USA.
Shannon GillespieCollege of Nursing, The Ohio State University, Columbus, OH, USA.
Anna M StrahmDepartment of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Jonathan SchaffirDepartment of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Yevgeniya GokunCenter for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA.
Kyle PorterCenter for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA.

Funding

Stress, Race, and Immune Adaptation Across Pregnancy: Predictors of Preterm BirthR21HD067670 · NICHD · OHIO STATE UNIVERSITY · PI CHRISTIAN, LISA MICHELLE · 2011 to 2012
$419k
Physiological reactivity to acute stress during pregnancyR21HD061644 · NICHD · OHIO STATE UNIVERSITY · PI CHRISTIAN, LISA MICHELLE · 2009 to 2010
$402k
Eunice Kennedy Shriver National Institute of Child Health and Human Development HD067670NICHD NIH HHS R21 HD061644NICHD NIH HHS R21 HD067670NINR NIH HHS NR01366
6 · The paper itself

Abstract

STUDY

objectivesDelivery prior to full term affects 37% of US births, including ~400,000 preterm births (<37 weeks) and >1,000,000 early term births (37-38 weeks). Approximately 70% of cases of shortened gestation are spontaneous-without medically-indicated cause. Elucidation of modifiable behavioral factors would have considerable clinical impact.

methodsThis study examined the role of depressive symptoms and sleep quality in predicting the odds of spontaneous shortened gestation among 317 women (135 black, 182 white) who completed psychosocial assessment in mid-pregnancy.

resultsAdjusting for key covariates, black women had 1.89 times higher odds of spontaneous shortened gestation compared to White women (OR [95% CI] = 1.89 [1.01, 3.53], p = 0.046). Women who reported only poor subjective sleep quality (PSQI > 6) or only elevated depressive symptoms (CES-D ≥ 16) exhibited no statistically significant differences in odds of spontaneous shortened gestation compared to those with neither risk factor. However, women with comorbid poor sleep and depressive symptoms exhibited markedly higher odds of spontaneous shortened gestation than those with neither risk factor (39.2% versus 15.7% [OR (95% CI) = 2.69 (1.27, 5.70)], p = 0.01). A higher proportion of black women met criteria for both risk factors (23% of black women versus 11% of white women; p = 0.004), with a lower proportion experiencing neither risk factor (40.7% of black versus 64.3% of white women; p < 0.001).

conclusionsAdditive effects of poor subjective sleep quality and depressive symptoms were observed with markedly higher odds of spontaneous shortened gestation among women with both risk factors. Racial inequities in rates of comorbid exposure corresponded with inequities in shortened gestation. Future empirical studies and intervention efforts should consider the interactive effects of these commonly co-morbid exposures.

Indexed as

DepressionPremature BirthBlack PeopleFemaleHumansInfant, NewbornParturitionPregnancySleepdepressiondepressive symptomsearly term birthmental healthpregnancypreterm birthracial inequitiesshortened gestationsleep

Identifiers

PMID34019675
PMCPMC8598176

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.