Newborns' sleep-wake patterns: the role of maternal,delivery and infant factors

Objective: The purpose of this study was to assess the sleep-wake patterns of fullterm (≥37 weeks) newborns and to evaluate the effects of specific factors including maternal gestational diabetes, infant size and anthropometric measures, gender, gestational age and delivery variables. Methods: Two-hundred twenty newborns were studied in the hospital nursery for a continuous 24-h period with miniature activity monitors attached to the infants' ankles. The sample consisted of 102 infants of gestational diabetic mothers (IGDM) and 118 controls. Anthropometric measurements were obtained and maternal and infant characteristics were recorded. Results: The newborns had a discernible diurnal steep pattern and slept twice as much during the nighttime as daytime hours (P < 0.001). Higher skinfold measurements correlated significantly with increased quiet and motionless sleep (P < 0.05) for the IGDM but not for controls. Sleep of infants born at later gestational ages was characterized by increased percent of quiet and motionless sleep (P < 0.0001). No direct gender effects were identified. Conclusions: Multiple factors were associated with the sleep-wake patterns of the newborns on our study cohort including maternal glucose values during pregnancy, increased measures of adiposity in IGDM, increased gestational age, mode of delivery and delivery Sequence. Investigation of the sleep-wake characteristics of neonates using activity monitors is a noninvasive method for gaining new understanding of the relationships between sleep wake activity patterns and infant characteristics.