Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Ben Taub General Hospital, Houston, TX, USA.
Am J Obstet Gynecol. 2010 Jun;202(6):552.e1-7. doi: 10.1016/j.ajog.2009.12.008. Epub 2010 Feb 20.
Obstructive sleep apnea (OSA) involves episodic nocturnal apneas. Using polysomnography, we examined the predictive capacity of screening questionnaires (Berlin) in pregnancy. Incorporating simultaneous fetal heart rate monitoring (FHM), we examined the association of maternal apnea with FHM abnormalities.
We enrolled 100 pregnant women at 26-39 weeks of gestation with OSA screening and baseline data ascertainment who underwent polysomnography and FHM for > or =3 hours. The relationship between maternal characteristics, OSA, and FHM was explored with multivariate analyses that were controlled for potential confounders.
When compared with polysomnography, sensitivity and specificity by Berlin screening was 35% and 63.8%, respectively; the snoring component of the Berlin correlated better with oxygen desaturation <95% (P = .003). Body mass index was a significant confounder (r(s) = 0.44; P < .0001). No association was observed between FHM abnormalities and OSA parameters.
In pregnancy, the Berlin questionnaire poorly predicts OSA. It is unclear whether fetal compromise during maternal apnea is a mechanism in OSA that is related to pregnancy outcome.
阻塞性睡眠呼吸暂停（OSA）涉及间歇性夜间呼吸暂停。我们使用多导睡眠图检查了妊娠筛查问卷（柏林）的预测能力。结合同时的胎儿心率监测（FHM），我们研究了母体呼吸暂停与 FHM 异常的关系。
我们招募了 100 名妊娠 26-39 周的孕妇，进行 OSA 筛查和基线数据确定，这些孕妇接受了多导睡眠图和 FHM 监测>或=3 小时。通过多变量分析探讨了母体特征、OSA 和 FHM 之间的关系，并控制了潜在的混杂因素。
与多导睡眠图相比，柏林筛查的敏感性和特异性分别为 35%和 63.8%；柏林的打鼾成分与氧饱和度<95%的相关性更好（P=0.003）。体重指数是一个显著的混杂因素（r(s)=0.44；P<0.0001）。FHM 异常与 OSA 参数之间没有观察到相关性。
在妊娠中，柏林问卷对 OSA 的预测能力较差。目前尚不清楚母体呼吸暂停期间胎儿窘迫是否是与妊娠结局相关的 OSA 机制。
