Mom’s sleep position during pregnancy may affect stillbirth risk
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July 10, 2011HealthDay reported that pregnant women who sleep on their back or right side have “twice the risk of having a stillborn infant” as women who sleep on their left side, according to a study in BMJ.
Researchers interviewed “155 women who delivered a stillborn baby at least 28 weeks’ gestation” and compared them with “310 pregnant women with typical ongoing pregnancies.”
The women were asked about their “sleep position during the last month of their pregnancy, the last week of their pregnancy, and on the night they believed the stillbirth occurred.”
Women who slept on their “back or on their right side on the night before a stillbirth were twice as likely to have a late stillbirth,” compared with women who slept on their left side.
MedPage Today reported that the researchers noted that women whose offspring were stillborn “typically were heavier, of lower socioeconomic status, and smokers.”
Meanwhile, an editorial accompanying the study “advised caution in interpreting these findings. ‘A forceful campaign urging pregnant women to sleep on their left side is not yet warranted,’” the editorialists wrote.
Nevertheless, I see no harm in letting women know of this study and I’ll be recommending women who are pregnant sleep on their left side … until other data are available.
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This makes some sense anatomically given how the major blood vessels are located in the abdomen. We position women having C-sections slightly tipped to the left as well, to avoid pressure on the major veins and arteries. That being said, we need to be careful about relative risk and absolute risk. That is to say, the risk may be twice as high, but twice as high as what? What’s the baseline still birth weight among women who are heavier, have lower socio-economic status, and are smokers? I also worry a little about recall bias. Women who are unfortunate enough to have a late term stillbirth will in theory be casting about for any reason that it happened, so there may be over-reporting of back or R side sleeping.