Mothers’ Poor Sleep Quality in Late Pregnancy Linked to Higher Obesity Risk in Their Children

New research has found that mothers with poor sleep quality in late pregnancy had babies with lower weight in the first 6 months of life, but higher weight after age 1-2 years. This effect was strongest in male infants and in babies born at term. The findings from the studyopens in new tab/window in the American Journal of Preventive Medicineopens in new tab/window, published by Elsevier, suggest that incorporating sleep quality assessments into routine prenatal care could facilitate early identification of at-risk pregnancies, and addressing poor sleep quality could be beneficial for the health of both mother and child.

Sleep health in pregnancy and childhood obesity are two major and modifiable public health concerns. Global childhood and adolescent obesity rates have more than doubled from 1990 to 2022, now affecting more than 390 million children aged 5-19 years.

Studies have found that poor sleep health is associated with various health conditions, including diabetes, obesity, and cardiovascular diseases. Human and animal studies have also suggested that pregnancy sleep quality can serve as a factor in the intergenerational transmission of obesity risk from mother to child.

Rapid weight gain during infancy is a risk factor for obesity in later childhood. Understanding the effects of pregnancy sleep health on early childhood growth trajectories could help mitigate impacts on children’s metabolic health.

Most previous research has been cross-sectional or conducted in children over 2 years old. Furthermore, the association between pregnancy sleep health and childhood obesity has not been extensively studied in Hispanic populations in the US, which have higher rates of being overweight or obese compared to other racial or ethnic groups.

This study investigated a group of 645 mother-child pairs from the prospective pregnancy cohort Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) in Los Angeles. Researchers evaluated late-pregnancy sleep quality using the Jenkins Sleep Scale questionnaire. Height and weight of children were measured at follow-up visits at the University of Southern California clinic or abstracted from medical records.

Most mothers reported mild to moderate sleep disturbance but 26% of mothers had poor sleep quality. Children whose mothers reported the worst sleep quality had lower weights from birth to 6 months but had higher weights thereafter. At 1 year of age, the difference in weight was 346.7 grams, and the greatest difference was observed at 17 months (751.5 grams).

The study underscores the importance of maintaining good pregnancy sleep health. The findings suggest that the observed associations are primarily driven by poor late-pregnancy sleep quality and are not explained by other traditionally identified prenatal and postnatal factors such as childhood feeding practices.

Senior author Carrie V. Breton, MPH, PhD, Professor at the Bursky School of Public Health, Washington University in St. Louis, and Adjunct Professor in the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, says, “Our research supports the notion that exposures during critical developmental windows of pregnancy can program offspring health. Several biological mechanisms may link late-pregnancy sleep health to children’s weight trajectories. For instance, poor sleep may affect maternal or child metabolic health programming, or both, which in turn could affect neonatal fat mass distribution and lead to abnormal lipid profiles or higher inflammation. Alternatively, stress pathways associated with higher childhood obesity risk may also play a role.”

Lead author Xiaoran Yang, MPH, PhD graduate from the Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, adds, “Poor sleep health in pregnancy is common and often overlooked, and our findings suggest that monitoring it in routine prenatal care could be a simple and powerful step toward healthier growth for the next generation.”

Notes for editors

The article is “Self-Reported Sleep Quality in Late Pregnancy Is Associated With Early-Childhood Growth Trajectories in Children Aged 0−2 Years in Hispanic Populations,” by Xiaoran Yang, PhD, Sandrah P. Eckel, PhD, Erika Garcia, PhD, Tingyu Yang, MS, Xinci Chen, MS, Brendan Grubbs, MD, Laila Al-Marayati, MD, Claudia M. Toledo-Corral, PhD, Jill Johnston, PhD, Kathleen A. Page, MD, Genevieve F. Dunton, PhD, Shohreh F. Farzan, PhD, Theresa M. Bastain, PhD, and Carrie V. Breton, PhD (https://doi.org/10.1016/j.amepre.2026.108546opens in new tab/window). It appears online in the American Journal of Preventive Medicine, published by Elsevier.

The article is openly available at https://www.ajpmonline.org/article/S0749-3797(26)00289-8/fulltextopens in new tab/window.

Full text of this article is also available to credentialed journalists upon request; contact Astrid Engelen at +31 6 14395474 or [email protected]opens in new tab/window. Journalists wishing to interview the authors should contact Xiaoran Yang, MPH, at [email protected]opens in new tab/window.

This work was supported by the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center (grant numbers P50ES026086 and P50MD015705), funded by the National Institute of Environmental Health Sciences and the National Institute for Minority Health and Health Disparities. Additional support was provided by the Lifecourse Approach to Developmental Repercussions of Environmental Agents on Metabolic and Respiratory health (LA DREAMERs; grant number UH3OD023287), part of the National Institutes of Health Office of the Director ECHO Program.

About the American Journal of Preventive Medicine

The American Journal of Preventive Medicineopens in new tab/window is the official journal of the American College of Preventive Medicineopens in new tab/window and the Association for Prevention Teaching and Researchopens in new tab/window. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials. www.ajpmonline.orgopens in new tab/window

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