Fetal and infant growth patterns, sleep, and 24-h activity rhythms: a population-based prospective cohort study in school-age children

Victoria A.A. Beunders*, M. Elisabeth Koopman-Verhoeff, Marijn J. Vermeulen, Carolina C.V. Silva, Pauline W. Jansen, Annemarie I. Luik, Irwin K.M. Reiss, Koen F.M. Joosten, Vincent W.V. Jaddoe

*Corresponding author for this work

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The study objective was to explore associations of fetal and infant weight patterns and preterm birth with sleep and 24-h activity rhythm parameters at school-age. In our prospective population-based study, 1327 children were followed from birth to age 10–15 years. Fetal weight was estimated using ultrasound in the second and third trimester of pregnancy. Birth weight and gestational age were available from midwife registries. Infant weight was measured at 6, 12 and 24 months. Fetal and infant weight acceleration or deceleration were defined as a change of >0.67 standard deviation between the corresponding age intervals. At school-age, sleep duration, sleep efficiency, wake after sleep onset, social jetlag, inter-daily stability, and intra-daily variability were assessed using tri-axial wrist actigraphy for 9 consecutive nights. We observed that low birth weight (<2500 g) was associated with 0.24 standard deviation (95% confidence interval [CI] 0.04; 0.43) longer sleep duration compared to normal weight. Compared to normal growth, growth deceleration in fetal life and infancy was associated with 0.40 standard deviation (95% CI 0.07; 0.73) longer sleep duration, 0.44 standard deviation (95% CI 0.14; 0.73) higher sleep efficiency, and −0.41 standard deviation (95% CI −0.76; -0.07) shorter wake after sleep onset. A pattern of normal fetal growth followed by infant growth acceleration was associated with −0.40 standard deviation (95% CI −0.61; −0.19) lower inter-daily stability. Preterm birth was not associated with any sleep or 24-h rhythm parameters. Our findings showed that children with fetal and infant growth restriction had longer and more efficient sleep at school-age, which may be indicative of an increased need for sleep for maturational processes and development after a difficult start in life.

Original languageEnglish
Article numbere13822
JournalJournal of Sleep Research
Issue number4
Early online date27 Jan 2023
Publication statusPublished - Aug 2023

Bibliographical note

Funding Information:
Erasmus Medisch Centrum; H2020 European Research Council, Grant/Award Number: ERC‐2014‐CoG‐648916; Ministerie van Volksgezondheid, Welzijn en Sport; Netherlands Organization for Scientific Research; ZonMw Funding information

Funding Information:
Financial disclosure: the general design of the Generation R Study is made possible by financial support from the Erasmus MC, Rotterdam; Netherlands Organization for Health Research and Development (ZonMw); Netherlands Organization for Scientific Research (NWO); Ministry of Health, Welfare and Sport, and Ministry of Youth and Families. V.W.V.J. received a grant of the European Research Council (Consolidator Grant, ERC‐2014‐CoG‐648916). The financial supporters did not influence the results of this article.

Publisher Copyright:
© 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.


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