Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, OH, USA.
Am J Obstet Gynecol. 2010 Mar;202(3):261.e1-5. doi: 10.1016/j.ajog.2009.10.867. Epub 2009 Dec 14.
The objective of the study was to estimate the maternal and neonatal morbidities associated with obstructive sleep apnea (OSA) in pregnancy.
Women delivering between 2000-2008 with confirmed OSA in an academic center were included. Normal-weight and obese controls were randomly selected at a 2:1 ratio. Maternal and neonatal morbidities were compared between the groups. Multivariate analyses were performed to evaluate maternal morbidity and preterm birth (PTB).
The analysis included 57 pregnancies complicated by OSA. Compared with normal-weight (n = 114) controls, OSA patients had more preeclampsia (PET) (19.3% vs 7.0%; P = .02) and PTB (29.8% vs 12.3%; P = .007). Controlling for comorbid conditions, OSA was associated with an increased risk of PTB (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.02-6.6), mostly secondary to PET (63%). Cesarean delivery (OR, 8.1; 95% CI, 2.9-22.1) and OSA were associated with maternal morbidity (OR, 4.6; 95% CI, 1.5-13.7).
Pregnancies complicated by OSA are at increased risk for preeclampsia, medical complications, and indicated PTB.
本研究旨在评估妊娠期阻塞性睡眠呼吸暂停（OSA）相关的孕产妇和新生儿发病率。
本研究纳入了在学术中心确诊为 OSA 并于 2000-2008 年间分娩的女性。正常体重和肥胖对照组按 2:1 的比例随机选择。比较了各组之间的孕产妇和新生儿发病率。进行了多变量分析以评估孕产妇发病率和早产（PTB）。
该分析纳入了 57 例并发 OSA 的妊娠。与正常体重（n=114）对照组相比，OSA 患者发生子痫前期（PET）（19.3% vs 7.0%；P=.02）和早产（PTB）（29.8% vs 12.3%；P=.007）的比例更高。控制合并症后，OSA 与 PTB 的风险增加相关（比值比[OR]，2.6；95%置信区间[CI]，1.02-6.6），主要是由 PET（63%）引起的。剖宫产（OR，8.1；95% CI，2.9-22.1）和 OSA 与孕产妇发病率相关（OR，4.6；95% CI，1.5-13.7）。
并发 OSA 的妊娠发生子痫前期、医疗并发症和有指征的 PTB 的风险增加。
