Department of Obstetrics and Gynaecology, University of Auckland, Private Bag 92019 Auckland 1142, New Zealand.
BMJ. 2011 Jun 14;342:d3403. doi: 10.1136/bmj.d3403.
To determine whether snoring, sleep position, and other sleep practices in pregnant women are associated with risk of late stillbirth.
Prospective population based case-control study.
Auckland, New Zealand
155 women with a singleton late stillbirth (≥ 28 weeks' gestation) without congenital abnormality born between July 2006 and June 2009 and booked to deliver in Auckland.
310 women with single ongoing pregnancies and gestation matched to that at which the stillbirth occurred. Multivariable logistic regression adjusted for known confounding factors.
Maternal snoring, daytime sleepiness (measured with the Epworth sleepiness scale), and sleep position at the time of going to sleep and on waking (left side, right side, back, and other).
The prevalence of late stillbirth in this study was 3.09/1000 births. No relation was found between snoring or daytime sleepiness and risk of late stillbirth. However, women who slept on their back or on their right side on the previous night (before stillbirth or interview) were more likely to experience a late stillbirth compared with women who slept on their left side (adjusted odds ratio for back sleeping 2.54 (95% CI 1.04 to 6.18), and for right side sleeping 1.74 (0.98 to 3.01)). The absolute risk of late stillbirth for women who went to sleep on their left was 1.96/1000 and was 3.93/1000 for women who did not go to sleep on their left. Women who got up to go to the toilet once or less on the last night were more likely to experience a late stillbirth compared with women who got up more frequently (adjusted odds ratio 2.28 (1.40 to 3.71)). Women who regularly slept during the day in the previous month were also more likely to experience a late stillbirth than those who did not (2.04 (1.26 to 3.27)).
This is the first study to report maternal sleep related practices as risk factors for stillbirth, and these findings require urgent confirmation in further studies.
探讨孕妇打鼾、睡眠姿势和其他睡眠习惯与晚期死胎风险之间的关系。
前瞻性基于人群的病例对照研究。
新西兰奥克兰。
2006 年 7 月至 2009 年 6 月期间，155 名单胎晚期死胎（≥28 周妊娠）且无先天性异常的孕妇，均在奥克兰分娩。
310 名单胎继续妊娠且与死胎发生时孕周相匹配的孕妇。采用多变量逻辑回归调整已知混杂因素。
孕妇打鼾、白天嗜睡（用 Epworth 嗜睡量表测量）以及入睡时和醒来时的睡眠姿势（左侧、右侧、背部和其他）。
本研究中晚期死胎的发生率为 3.09/1000 例。打鼾或白天嗜睡与晚期死胎风险之间无相关性。然而，与睡在左侧的孕妇相比，前一晚（死胎或访谈前）睡在背部或右侧的孕妇更有可能发生晚期死胎（背部睡眠的调整比值比为 2.54（95%CI 1.04 至 6.18），右侧睡眠为 1.74（98%CI 0.98 至 3.01））。睡在左侧的孕妇发生晚期死胎的绝对风险为 1.96/1000，而不左侧睡眠的孕妇为 3.93/1000。与夜间频繁起床的孕妇相比，前一晚仅起床一次或更少的孕妇更有可能发生晚期死胎（调整比值比为 2.28（1.40 至 3.71））。与不经常在过去一个月白天睡觉的孕妇相比，经常在白天睡觉的孕妇更有可能发生晚期死胎（2.04（1.26 至 3.27））。
这是第一项报道与孕妇睡眠相关行为为死胎危险因素的研究，这些发现需要在进一步研究中紧急确认。
