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These risk factors may predispose infants to abnormal brain development and respiratory problems which may lead in turn to sleep problems in post-term children. Post-term delivery often has a higher risk for perinatal problems such as prolonged labour that can cause a perinatal lack of oxygen and uteroplacental insufficiency. It has also been reported that, with respect to longer-term effects, post-term birth increases the risks of cognitive impairments, severe mental disorders, neuropsychological disorders, and other behavioural and emotional problems in early childhood. Post-term birth can increase the risk of neonatal encephalopathy and death during the first year of life. Studies have reported that post-term birth can negatively affect children’s short-term and long-term health outcomes.

Moreover, to our knowledge, no study has been conducted to date on the sleep outcomes of post-term-born children (>41 weeks). However, given the very limited studies available in the literature, variation in the degrees of prematurity and sample size makes it difficult to draw any clear conclusions about the sleep outcomes of preterm children beyond infancy. For example, increased parental concern about preterm children may be linked to earlier bedtimes, which may contribute to the different sleep outcomes of preterm children beyond infancy. Furthermore, a range of parental factors related to preterm childcaring may also play a role. It has been suggested that irreversible adverse factors related to preterm birth, such as brain injury, altered brain maturation, and respiratory problems may precipitate poor sleep. Preterm children have been reported to have lower sleep quality, including more nocturnal awakenings, and consistent with this more “shallow” and less “deep” non-rapid eye movement sleep. Studies have suggested that school-aged preterm children had different sleep patterns compared to full-term children, such as having earlier bedtimes and earlier wake times, but had no difference in overall sleep duration. However, the exact relationship between preterm birth and sleep problems beyond infancy is not yet clear. In preterm infants younger than 1 year old, sleep problems are thought to be even more prevalent. However, sleep problems are relatively common among young children, and according to parent reports, it has been suggested that approximately 20–30% of young children have various sleep problems. It is well established that both sleep quality and quantity are essential for normal brain development throughout childhood, particularly for cognitive functions. Preterm, early-term, and post-term should therefore all be monitored with an increased threat of sleep disorder that requires long-term monitoring for adverse sleep outcomes in preschoolers. ConclusionsĮvery degree of premature, early-term and post-term birth, compared to full-term, has an association with sleep disorders and shortened daily sleep duration. Preterm and post-term-born children had different sleep profiles as suggested by subscales of the CSHQ. 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<0.01. Linear regressions and logistic regression models were applied to examine gestational age at birth with the sleep outcomes of children. Children’s daily sleep hours and pediatric sleep disorders defined by the Children’s Sleep Habits Questionnaire (CSHQ) were reported by parents. MethodsĪ national retrospective cohort study was conducted with 114,311 children aged 3–5 years old in China. Our study investigated the sleep outcomes of children born at very-preterm (41 weeks).

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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 have not been examined.

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