Nat Sci Sleep:孕早期阻塞性睡眠呼吸暂停高危可能增加妊娠糖尿病发病风险

2022-06-27 影像小生 MedSci原创

孕早期OSA的高风险会增加GDM的几率

妊娠糖尿病(GDM)是指在妊娠期间发病或首次发现的任何程度的高血糖,是最常见的妊娠相关疾病。睡眠是人类生活的重要组成部分。它的功能非常复杂,不同的睡眠障碍相互影响。女性睡眠障碍的患病率为17.7%至25.1%睡眠障碍主要包括失眠、睡眠相关呼吸障碍、嗜睡症等。

睡眠障碍与GDM之间的关系已经引起了越来越多的关注。大部分研究集中在妊娠前、中期睡眠状态对GDM的影响,结论仍存在争议。研究发现,改善怀孕前的生活行为,包括定期锻炼和补充叶酸,可以减少GDM的发生。孕前睡眠状态作为生活行为的重要组成部分,与GDM之间的关系尚不明确。睡眠障碍的干预需要一定的过程。对于孕妇来说,无论睡眠障碍与哪个阶段的GDM有关,通过改善睡眠来减少GDM发生的时间都是非常有限的。此外,大多数关于睡眠分布与GDM之间关系的研究仅集中在一个或两个维度,如睡眠时间、睡眠质量或阻塞性睡眠呼吸暂停OSA

Nat Sci Sleep最近刊发了北京大学第三医院Yan Wang等的研究结果,探讨了妊娠前睡眠障碍与妊娠期糖尿病(GDM)发生风险的关系。因此,本研究旨在探讨孕期睡眠时间短、睡眠质量差、OSA高危等睡眠障碍是否为妊娠期继发GDM的危险因素。

该研究选取2019年9月至2020年6月期间妊娠12周之前到产前诊所就诊的孕妇。通过填写匹兹堡睡眠质量指数(PSQI)和柏林问卷(BQ)收集最后一个月经前一个月的睡眠状态,评估睡眠时间、质量和OSA的风险。通过每月一次的产前护理,在24 - 28孕周进行口服葡萄糖耐量试验(OGTT)。根据结果分为GDM组和非GDM组。比较两组患者的睡眠状态和基线特征。

共纳入355例孕妇,其中63例(17.7%)被诊断为GDM。

1.    单因素分析显示,产妇年龄、体重指数(BMI)、糖尿病家族史、PSQI评分及BQ阳性与GDM相关(p < 0.05)

2.    多因素分析显示,产妇年龄(aOR 1.10, 95% CI, 1.01-1.17)孕前BMI (aOR 1.12, 95% CI, 1.02-1.23)糖尿病家族史(aOR 2.35, 95% CI, 1.33-4.17)BQ(aOR 4.03, 95% CI, 1.04-15.63)是GDM的独立危险因素。

3.    决策树结果显示,在BMI > 20.6 kg/m2,年龄> 28.5, BQ阳性GDM的风险从27.5%增加到66.7%。

该研究采用两种量表对妊娠前睡眠障碍进行评估,以评估其与妊娠糖尿病后续发生的关系。孕早期OSA的高风险会增加GDM的几率。保健专业人员应评估孕妇的睡眠障碍,以改善妊娠结果。

原文出处

Song Y, Wang L, Zheng D, Zeng L, Wang Y. Sleep Disturbances Before Pregnancy and Subsequent Risk of Gestational Diabetes Mellitus. Nat Sci Sleep. 2022;14:1165-1174
https://doi.org/10.2147/NSS.S363792

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    2022-10-20 tomyang96
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    2023-05-18 liye789132251
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