1421-P: Associations of Sleep Disturbances Before and During Early Pregnancy with Increased Risk of Gestational Diabetes

Women with sleep disturbances before or during pregnancy may be at high risk for gestational diabetes (GDM) due to poor sleep-related increases in insulin resistance. To estimate associations of habitual snoring and other sleep disturbances before and during early pregnancy with GDM risk, we combined data collected as part of two prospective pregnancy cohort studies at Kaiser Permanente Northern California that used the same sleep questionnaires (N=3,646, 2011-2018). In early pregnancy (7-22 weeks gestation) participants self-reported snoring frequency in the 12 months before becoming pregnant and since becoming pregnant. Snoring most or some of the time was considered habitual snoring. Participants also reported if they had trouble falling asleep in early pregnancy. Three hundred four (8%) women were diagnosed with GDM based on laboratory glucose values meeting the Carpenter and Coustan criteria. Forty-four percent of women reported habitual snoring prior to pregnancy and 45% in early pregnancy. Thirty-one percent of women reported trouble falling asleep in early pregnancy. In logistic regression models adjusted for maternal age, race/ethnicity, pre-pregnancy BMI, and parity, habitual snoring prior to pregnancy was associated with a 33% greater odds of GDM (OR [95% CI]: 1.33 [1.00, 1.77]) compared to no snoring. Habitual snoring in early pregnancy was not statistically significantly associated with GDM (1.14 [0.84, 1.53]). Trouble falling asleep in early pregnancy was borderline significantly associated with greater GDM risk (1.27 [0.98, 1.66]). Our findings suggest that snoring prior to pregnancy and other sleep disturbances during early pregnancy are associated with greater risk of GDM. Studies with objective measures of sleep are needed to confirm these findings and prior to designing interventions to reduce sleep disturbances to decrease risk for GDM.