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Link Between Pregnancy Sleep and Activity Patterns and Premature Birth Risk

New research led by the Stanford School of Medicine has uncovered a significant connection between pregnancy sleep physical activity patterns and the risk of premature birth. In this comprehensive exploration, we dive into the study’s findings and what it means for expectant mothers.

Reduced Sleep and Activity: A Risk for Premature Birth; Recent research, set to be published online on September 28 in npj Digital Medicine, reveals a compelling link between reduced sleep and physical activity during pregnancy and the heightened risk of preterm birth. Here, we unpack the details of this groundbreaking study.

Understanding the Study; The study harnessed the power of wearable devices, collecting data from over 1,000 pregnant women throughout their pregnancies. Employing advanced machine learning algorithms, researchers meticulously examined participants’ activity information to uncover subtle alterations in sleep and physical activity patterns.

Building an Artificial Intelligence “Clock”; Lead study author Nima Aghaeepour, PhD, described how an artificial intelligence algorithm can construct a precise “clock” tracking physical activity and sleep during pregnancy. This clock can accurately gauge the progress of a pregnancy. Normal pregnancies follow a predictable pattern of changing sleep and physical activity, but deviations from this pattern can signal a warning for premature birth.



Key Insights from the Study; As pregnancies advanced, the study highlighted a common trend: sleep disturbances increased, and physical activity decreased. However, a subset of women displayed accelerated changes in their sleep and activity patterns relative to their pregnancy stage. Strikingly, these women were more likely to experience premature deliveries.

AI’s Role in Identifying Risk; Aghaeepour emphasized the AI algorithm’s ability to identify women who, despite not appearing “very pregnant” visually, faced a significantly higher risk of preterm birth. This underscores the potential of AI in predicting pregnancy outcomes.

The Significance of Preventing Premature Birth; Premature birth, defined as a baby being born three or more weeks early, affects approximately 10.5% of births in the United States, with even higher rates in some regions globally. Premature newborns are susceptible to numerous medical complications, making prematurity the leading cause of child mortality worldwide.

Challenges in Identifying At-Risk Pregnancies; While various risk factors for premature delivery have been identified, reliably pinpointing at-risk pregnancies remains a challenge. Even when risk factors are known, effective treatments to prolong pregnancies are limited, given ethical concerns about potential harm to the fetus from drug testing.

The Potential for Interventions; By recognizing sleep and activity patterns that correlate with lower prematurity risk, researchers aim to develop interventions that encourage expectant mothers to adopt healthier sleep and exercise habits. This approach offers a promising, low-risk strategy for reducing preterm births.

Inclusivity in Research; The study, conducted in collaboration with scientists at Washington University in St. Louis, included a diverse group of participants, with more than half being Black. This diversity acknowledges the importance of studying preterm birth in populations facing higher risk due to factors like racism, socioeconomic status, and living conditions.

Data Collection and Insights; Participants wore actigraphy devices similar to smartwatches, recording minute-by-minute physical activity and light exposure from the first trimester until their babies were born. Researchers combined this data with electronic medical records to create a machine-learning model of activity and sleep during pregnancy.



Promising Predictions; Deviation from typical sleep and activity patterns emerged as a strong predictor of preterm birth. If the AI model categorized a woman as having better sleep and being more active than expected for her pregnancy stage, it correlated with a 48% reduction in preterm delivery risk. Conversely, deviations toward worse sleep and less activity led to a 44% higher risk.

A Path Forward; While these findings are preliminary, they point toward the potential of tracking and adjusting sleep and physical activity to reduce prematurity risk. The study encourages pregnant women to prioritize good sleep habits, maintain regular sleep schedules, get sufficient sleep, and seek natural light exposure for circadian regulation.

Looking to the Future; The study’s insights offer a promising direction for future interventions to reduce the rate of preterm birth. Researchers plan to explore whether improving sleep and physical activity during pregnancy can modulate other biological pathways linked to prematurity, such as inflammation control.

While further research is needed to fully understand the implications, advising pregnant women to maintain healthy sleep habits is a low-risk approach that may lead to significant benefits in reducing preterm births. The hope is that by optimizing sleep and physical activity, we can positively impact biology and decrease the incidence of premature birth.



1. What are the sleep pattern disturbances during pregnancy?

During pregnancy, sleep pattern disturbances are common. They may include increased nighttime awakenings, difficulty finding a comfortable sleep position due to a growing belly, more vivid dreams, and an overall feeling of restlessness. Hormonal changes and physical discomfort can contribute to these disruptions.

2. How does your sleep pattern change in early pregnancy?

In early pregnancy, some women may experience increased fatigue, leading to longer and more frequent daytime naps. However, nighttime sleep can become disrupted due to hormonal fluctuations and the need for more frequent trips to the bathroom. These changes can affect the quality and duration of sleep.

3. Can lack of sleep cause preterm labor?

While lack of sleep alone is not a direct cause of preterm labor, chronic sleep deprivation and poor sleep quality can contribute to increased stress and inflammation, which are risk factors for preterm birth. It’s essential for pregnant women to prioritize good sleep habits to reduce the risk of preterm labor.

4. What are the sleep patterns in the third trimester of pregnancy?

In the third trimester, sleep patterns can become more disrupted. As the baby grows, finding a comfortable sleep position becomes challenging. Frequent urination at night is common, and heartburn and leg cramps may also interfere with sleep. Additionally, the baby’s movements can be more pronounced and may wake the expectant mother during the night.

These changes in sleep patterns are typical during pregnancy, but maintaining a consistent sleep schedule, using pillows for support, and practicing relaxation techniques can help improve sleep quality.

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