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産後初期期間中における早産児の母親の睡眠パターンの経時的変化と特徴

宮野 まどか ミヤノ, マドカ Miyano, Madoka 神戸大学

2023.03.25

概要

Approximately 15 million babies every year are born preterm, i.e., before completing 37 weeks of gestation,
and this number is rising. In 184 countries, the rate of preterm birth has been reported to be low with an
incidence of 5%-18% (58). In Japan, the proportion of preterm infants is gradually increasing, although the total
number of births is decreasing, accounting for 5.6-5.7% of the total number of births since 2005(50).
Sleep plays an important role in human life. Sleep disorders are characterized by reduced sleep volume and
poor sleep quality, and they have been shown to affect the physical health, stress response, cognitive function,
memory, and mood adversely (3, 13, 55). Women's sleep during the perinatal period varies significantly due to
changes in the hormonal dynamics during pregnancy, delivery, and postpartum, and the childcare requirements
after childbirth. Especially in the early postpartum period, mothers have to awaken at night frequently in
response to the irregular life rhythm of the newborn (17, 38). The mother leads a life that matches and depends
on the sleep-wake cycle of the newborn, wherein the child sleeps and awakens every few hours in the early
postpartum period (19, 48). Following this, almost 80% of the term infants acquire a regulated circadian rhythm
around 8-11 weeks after birth, and at the same time, the mother's night sleep stabilizes (37).
On the other hand, mothers of preterm infants are admitted to the neonatal intensive care unit (NICU)
because their infants need treatment; hence, it may be assumed that the mothers do not experience sleep
interruption as childcare is not required, and the effect on their sleep is limited. However, it has been reported
that mothers of preterm infants in the early postpartum period are prone to sleep deprivation due to stress (35,
56). In addition, preterm infants are more likely to have more sleep disorders than full-term infants, and sleep
disorders may persist throughout childhood (22), suggesting a greater impact on mothers.
Sleep problems in postpartum women are also closely related to maternity blues and subsequent postpartum
depression due to changes in the hormonal balance. However, it is reported that these problems could be related
to the interrupted nighttime sleep due to childcare, fatigue after labor, and postpartum depression. These reports
have limited evidence because of the different evaluation methods used and the differences in the factors
evaluated. Furthermore, there are only few longitudinal studies on the adaptive process of sleep behaviors for
mothers with preterm infants during home care after the mother-infant separation period. ...

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