Morningness/eveningness in gestational diabetes mellitus: clinical characteristics and maternal-neonatal outcomes

Sep 26, 2022Archives of endocrinology and metabolism

Morning or evening activity patterns in gestational diabetes: health traits and outcomes for mothers and babies

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Abstract

Among 305 patients with gestational diabetes mellitus, 6.9% exhibited evening preference.

Patients with evening preference reported worse sleep quality, greater insomnia, fatigue, and depressive symptoms.
Evening chronotype was linked to an increased risk of preeclampsia and higher likelihood of neonatal intensive care unit admission.
A lower score on the Morningness-Eveningness Questionnaire was associated with preeclampsia, even after adjusting for various factors.

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OBJECTIVE: This study aims to evaluate the impact of morning-evening preference in pregnancy outcomes in gestational diabetes mellitus (GDM).

METHODS: This is a prospective cohort study of 2nd-3rd trimester GDM outpatient care in Fortaleza, Brazil (2018-2020). Eveningness was defined by the Horne-Östberg Morningness-Eveningness-Questionnaire (MEQ ≤ 41). Furthermore, we obtained a 7-day actigraphic register. Subjective sleep quality, daytime somnolence, insomnia, fatigue and depressive symptoms were also evaluated. Associations with pregnancy outcomes were investigated.

RESULTS: Among 305 patients with GDM, evening preference was found in 21 (6.9%). Patients with evening preference had worse sleep quality (p < 0.01), greater severity of insomnia (p < 0.005), fatigue (p < 0.005) and depressive symptoms (<0.009). Evening chronotype was associated with preeclampsia [p = 0.01; OR = 0.27; CI 0.09-0.79] and a greater need for admission to a neonatal intensive care unit (NICU) [p = 0.02; OR = 0.23; CI .0.06-0.80]. A lower MEQ score confirmed an association with preeclampsia [p = 0.002; OR = 0.94; CI 0.90-0.97] and this was maintained after controlling for age, arterial hypertension, sleep quality, fatigue and depressive symptoms [p < 005; OR = 0.91; CI 0.87-0.95].

CONCLUSION: In GDM, patients with evening preference had worse sleep quality, more insomnia, fatigue, and depressive symptoms. Furthermore, eveningness was independently associated with preeclampsia. These results indicate the important role of eveningness in adverse pregnancy outcomes.

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Morningness/eveningness in gestational diabetes mellitus: clinical characteristics and maternal-neonatal outcomes

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