Relations Between Prenatal Sleep Health and Maternal Weight Retention 2 to 7 Years After a First Birth: The NuMoM2b-HHS

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Abstract Background Poor prenatal sleep health is associated with greater gestational weight gain, but the contributions to longer-term maternal weight retention remain unclear. Purpose To examine associations between prenatal sleep health across multiple domains and maternal weight retention 2–7 years after a first birth. Methods Participants were from the nuMoM2b-Heart Health Study. Self-reported sleep was assessed during early (6-13 6/7 weeks) and mid-pregnancy (22–28 6/7 weeks) across six domains: regularity, quality, sleepiness, timing, efficiency, and duration. A multidimensional sleep health (MSH) score reflected the number of domains meeting healthy thresholds. Outcomes included maternal weight retention, total and substantial ( > 11 lbs.), from pre-pregnancy to 2–7 years after a first birth. Associations were estimated using adjusted linear regression for total weight retention and Poisson regression with robust variance for substantial weight retention. Results The sample included 3,661 individuals with data in early (n = 2,962) and mid-pregnancy (n = 3,210). In early pregnancy, healthy sleep duration was associated with lower total weight retention, whereas healthy sleep regularity was unexpectedly associated with greater retention. In contrast, during mid-pregnancy, a higher MSH score was associated with a lower risk of substantial weight retention (RR = 0.96, 95% CI: 0.93–0.99). Healthy sleep duration and quality were the two individual domains associated with lower weight retention (2–3 lbs.). Conclusions In a prospective cohort of pregnant nulliparous individuals, healthy prenatal sleep, particularly during mid-pregnancy, was associated with less maternal weight retention 2-7 years after delivery. Future studies should estimate the causal effects of sleep health on long-term maternal weight retention.

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