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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 2

Category: Epidemiology

Poster Session 2

(610) Risk of ischemic placental disease and preterm delivery among nulliparous individuals with insomnia

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Naima E. Ross, MD (she/her/hers)

    Maternal Fetal Medicine Fellow
    NYU Langone
    NYU Langone, New York, United States

    • Coauthor(s)

  • SF

    Steven Friedman, MS

    Associate Research Scientist
    Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine
    New York, New York, United States

  • RA

    Rashmi N. Aurora, MD, MS

    Associate Professor
    Department of Medicine, NYU Grossman School of Medicine
    New York, New York, United States

  • EH

    Erinn M. Hade, PhD

    Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine
    New York, New York, United States

  • Justin S. Brandt, MD (he/him/his)

    Associate Professor, Division Director, Fellowship Program Director
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, NYU Grossman School of Medicine
    New York, New York, United States

Objective:

To assess whether moderate/severe insomnia is associated with ischemic placental disease (IPD)—including preeclampsia (PEC), abruption, and fetal growth restriction (FGR)—and with preterm delivery (PTD).


Study Design:

We conducted a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring New Mothers-to-be (nuMoM2b), a prospective cohort of singleton, nulliparous individuals. We included those who underwent insomnia screening with the Women’s Health Initiative Insomnia Rating Scale (WHIRS) at either one or two of the study visits (at 6-14 weeks and/or 22-30 weeks). Moderate/severe insomnia was defined as WHI scores of 15-28 at either study visit. The primary outcome was IPD, defined as a composite of PEC, abruption, or FGR. Secondary outcomes included individual IPD components and preterm delivery < 37 weeks. Log-binomial regression estimated the relative risk between groups and corresponding 95% confidence intervals (CI), adjusted for pre-pregnancy depression and smoking.


Results:

Among 8,793 participants with WHI data, 5008 (57.0%) had moderate/severe insomnia at either visit. Pregnant people with moderate/severe insomnia were predominantly on average 27.2 years old (SD: 5.7), non-Hispanic/Latinx, White, and had a Bachelor’s degree or higher (Table 1). Additionally, they more often reported tobacco smoking (44.6% vs. 37.8%), gestational diabetes (5.2% vs 3.8%), and pre-pregnancy depression (13.9% vs. 7.8%). Among those with moderate/severe insomnia, the risk of PTD < 37 weeks (aRR 0.69, 95% CI 0.53, 0.91) was decreased. The risks of IPD (aRR 0.88, 95% CI 0.65, 1.24), including PEC (aRR 0.98, 95% CI 0.64, 1.49) and FGR (aRR 0.72, 95% CI 0.45, 1.23) were not increased. Additional outcomes, by insomnia status, are described in Table 2.


Conclusion:

Moderate/severe insomnia was not associated with increased risk for IPD or preterm birth in this large cohort of nulliparous individuals. These findings provide mechanistic insights, suggesting that insomnia related risks, if present, are not due to placental ischemia.