Sleeping in Supine position not associated with Pregnancy Complications, finds study

It's a popular belief that pregnancy and sleeping in supine position is not a good mix. A recent study has revealed that sleeping in supine position or on the back is not associated with Pregnancy Complications. The study appeared in the journal, Obstetrics & Gynecology.

The authors conducted a secondary analysis of a prospective observational multicenter cohort study of nulliparous women with singleton gestations where they observed that going to sleep in the supine or right lateral position, as self-reported before the development of pregnancy outcome and objectively assessed through 30 weeks of gestation, was not associated with an increased risk of stillbirth, a small-for-gestational-age newborn, or gestational hypertensive disorders.

Previous studies have linked sleeping on the back or right side to an increased risk of serious pregnancy complications because these positions may compress blood vessels supplying the uterus, researchers note in Obstetrics and Gynecology.

However, the current has come up with contrasting results

• Women in the current study were more likely to have serious pregnancy complications when they were overweight or obese, smoked or had high blood pressure or diabetes prior to pregnancy.


• Neither the positions women were in when they went to sleep or woke up nor the positions they might move to during the night appeared to impact the risk of complications.

“Some women may have trouble sleeping on their left side and they cannot control movement during sleep,” said the lead author Dr. Robert Silver, lead author of the study and chair of obstetrics and gynecology at the University of Utah School of Medicine in Salt Lake City.. “Even with careful messaging, there is potential to increase anxiety in women who wake up on their backs and guilt, shame and self-blame in women suffering adverse pregnancy outcomes such as stillbirth.”

Researchers examined data on outcomes for 8,709 pregnant women who completed at least one sleep questionnaire before they reached 30 weeks’ gestation. Overall, 1,903 women, or 22%, experienced serious complications like dangerously high blood pressure, stillbirth or a newborn small for its gestational age.

Women who slept on their right side or on their back were no more likely to experience serious complications than women who slept on their left side, the study found.

These results should reassure many pregnant women who might worry about harming their baby by sleeping on their back, or moving into this position during the night, said Dr. Robert Silver said. “There is a downside to encouraging the avoidance of supine (back) sleep,” he adds.

Researchers also looked at objectively-measured sleep positions for a subset of women who underwent home sleep studies for nighttime breathing problems. For these women, there also was no meaningful difference in the risk of pregnancy complications based on whether they slept on their back more than half of the time, or less often.

The study wasn’t designed to prove whether or how sleep positions might directly impact pregnancy outcomes. It also didn’t look at the connection between sleep position and complications in the final weeks of pregnancy.

One limitation of the study is that there were only about a dozen stillbirths – which may have been too few to detect meaningful differences in this outcome based on sleep position, the study team notes.

Even so, women should be reassured by the results, said Dr. Nathan Fox, a clinical professor at the Icahn School of Medicine at Mount Sinai and vice president at Maternal-Fetal Medicine Associates in New York City.

“Pregnant women should sleep in the position that they find most comfortable,” Fox, who co-wrote an editorial accompanying the study, said by email. “For the few that do experience complications of pregnancy, they should be reassured that it was not due to their sleeping position.”

To read the full study, please click on the link

DOI: 10.1097/AOG.0000000000003458