Associations between gestational age and childhood sleep: a national retrospective cohort study

Background: Both sleep quality and quantity are essential for normal brain development throughout childhood, however, the association between preterm birth and sleep problems in preschoolers is not yet clear, and the effects of gestational age across the full range from preterm to post-term has not been examined. Our study investigated the sleep outcomes of children born at very-preterm (41 weeks). Methods: A national retrospective cohort study was conducted with 114,311 children aged 3-5 years old in China. Children’s daily sleep hours and pediatric sleep disorders defined by the Children’s Sleep Habits Questionnaire (CSHQ) were reported by parents. Linear regressions and logistic regression models were applied to examine gestational age at birth with the sleep outcomes of children. Results: Compared with full-term children, a significantly higher CSHQ score, and hence worse sleep, was observed in very-preterm (β=1·827), moderate-preterm (β=1·409), late-preterm (β=0·832), early-term (β=0·233) and post-term (β=0·831) children, all p41) was also seen in very-preterm (adjusted odds ratio [AOR]=1·287 95% confidence interval [CI] (1·157, 1·433)), moderate-preterm (AOR=1·249 95% CI (1·110, 1·405)), late-preterm (AOR=1·111 95% CI (1·052, 1·174)), and post-term (AOR=1·139 95% CI (1·061, 1·222)), all p<0·001. Shorter sleep duration was also found in very-preterm (β=-0·303), moderate-preterm (β=-0·282), late-preterm (β=-0·201), early-term (β=-0·068), and post-term (β=-0·110) compared with full-term children, all p