UMMS Affiliation

Department of Quantitative Health Sciences; Department of Obstetrics and Gynecology; Department of Medicine, Division of Preventive and Behavioral Medicine

Faculty Mentor

Molly E. Waring

Publication Date


Document Type



Behavior and Behavior Mechanisms | Obstetrics and Gynecology | Women's Health


Background: Poor sleep in non-pregnant adults has been associated with increased evening snacking, which may contribute to weight gain. Sleep disturbances are common during pregnancy.

Objective: To examine the association between changes in sleep quality from pre-pregnancy and evening snacking.

Methods: In an ongoing prospective cohort study, pregnant women were recruited from UMMHC obstetric practices and the community. Participants are 18+ years, with singleton gestation <36 >weeks, pre-pregnancy BMI 18.5-40 kg/m2, English-speaking, and with plans to deliver at UMMHC. Participants were asked “compared to the three months before you became pregnant, how is your sleep quality now?”; we combined responses of “about the same”/“a little better”/“a lot better” versus “a little worse”/“much worse”. Participants completed three 24-hour dietary recalls (2 weekdays, 1 weekend day). Evening snacks were defined as eating occasions after dinner but before bedtime during which food items other than water was consumed. Fisher’s Exact tests and t-tests provided comparisons for evening snacking (yes/no), number of snacks, and energy intake.

Results: Women with complete data (n=55) were 58% non-Hispanic White and aged 30.0 (SD: 4.3) years; gestational age at study visit was 23.0 (SD: 5.9) weeks. Of 866 meals reported, 94 were evening snacks. 71% (n=39) reported that their current sleep quality was worse than before pregnancy. Evening snacks were reported by 90% of women reporting worse sleep and 69% same/better (p=0.1028). While the number of snacks among snackers did not differ by change in sleep quality (M[SD]: 2.2[1.2] versus 1.6[0.8], p=0.2372), energy intake from these snacks was higher among women whose sleep quality had declined (M[SD]: 630[488] versus 309[331] kcal, p=0.0480).

Conclusions: Declines in sleep quality during pregnancy may be linked to evening snacking. More research is needed to understand the role of sleep quality, eating behavior, and weight gain during pregnancy.


Pregnancy, Quality of sleep, Snacking

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2014 Senior Scholars Program Poster Presentation Day


Poster presented on Senior Scholars Program Poster Presentation Day at the University of Massachusetts Medical School, Worcester, MA, on April 30, 2014. Medical student Wendy McCallum participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

This poster was also presented at the University of Massachusetts Center for Clinical and Translational Science Research Retreat, Worcester, MA, on May 20, 2014.