Inflammation, Sleep, and Trait Mindfulness in Pregnancy

Objectives: Excessive systemic inflammation during pregnancy is a risk for adverse birth outcomes. Maternal sleep is related to systemic inflammation and may be modifiable through mindful thoughts and behaviors. In this cohort study, we explored the relationships among inflammation, sleep quality, and mindfulness during pregnancy.

Methods: Pregnant persons (N=122) 31.3 ± 5.3 years old, 32% self-identified Black and 57% self-identified White, were recruited during the 2nd - 3rd trimesters. Inflammation was assessed using interleukin-6 (IL-6). The Pittsburgh Sleep Quality Index was used to assess sleep quality, and the Three Facet Mindfulness Questionnaire was used to assess four mindfulness facets (i.e., overall mindfulness, non-judging to inner experience, non-reactivity to inner experience, acting with awareness). Relationships between inflammation, sleep quality, mindfulness, and the interaction between sleep and mindfulness were examined using linear regression.

Results: Lower inflammation (IL-6) was associated with higher acting with awareness (β = −0.20, 95% CI [−0.53, −0.05], p=.003). Higher inflammation was non-statistically significant with lower sleep quality (β = 0.19, 95% CI [−0.13, 0.35], p=.05). Controlling for covariates, the interaction between sleep quality and acting with awareness was significant (β = −0.63, 95% CI [−0.85, −0.40], p<.001), indicating that mindfulness may mitigate the relationship between poor sleep quality and higher inflammation.

Conclusions: In this sample, poor sleep quality was associated with higher levels of inflammation for women with lower levels of acting with awareness. Mindfulness interventions might be a cost-effective solution to decrease inflammation through improved sleep quality among pregnant women, potentially reducing adverse birth outcomes.