Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, 505, Banpo-dong Seocho-gu, Seoul 137-450, Korea.
Arch Gynecol Obstet. 2013 Mar;287(3):429-33. doi: 10.1007/s00404-012-2602-1. Epub 2012 Oct 21.
This study was intended to evaluate the attributable risk of obstructive sleep apnea (OSA) by a sleep questionnaire to adverse pregnancy outcomes.
This was a prospective, cohort study in Korean pregnant women. Berlin questionnaire was employed for symptom-based OSA screening during the third trimester and obstetric outcome data were obtained in 276 deliveries. The relationship between symptom-based OSA and outcomes were explored using SPSS version 18.0 and stratified by obesity (BMI strata <30 and ≥30). Our primary outcome was the compound occurrence of SGA (fetal) or preeclampsia (maternal). Multivariate models were applied in controlling for potential confounders.
The overall prevalence of OSA was 32.2 % and it was significantly related with the higher maternal BMI, more body weight at delivery, and weight gain during pregnancy (p = 0.007, p = 0.003, p = 0.005, respectively). There were no significant differences in the primary outcomes according to the positivity of OSA by screening, regardless of the stratification by obesity. The cesarean delivery rate was significantly higher in the OSA positive group (36.0 vs 22.5 %, p = 0.018), but it was not significant in the each strata of obesity. In multivariate analysis, the outcomes of birth weight, preeclampsia, cesarean delivery, and small for gestational age were also not different according to the positivity of OSA.
It seems that the prevalence of OSA by a sleep questionnaire is overestimating OSA in Korean pregnant women. Polysomnography might be needed to diagnose OSA and to evaluate the relationship between OSA and the occurrence of SGA or preeclampsia.
本研究旨在通过睡眠问卷评估阻塞性睡眠呼吸暂停（OSA）对不良妊娠结局的归因风险。
这是一项针对韩国孕妇的前瞻性队列研究。在妊娠晚期，采用柏林问卷进行基于症状的 OSA 筛查，并在 276 例分娩中获得产科结局数据。使用 SPSS 版本 18.0 探索基于症状的 OSA 与结局之间的关系，并按肥胖分层（BMI 分层<30 和≥30）。我们的主要结局是胎儿生长受限（SGA）或子痫前期（母亲）的复合发生。多变量模型用于控制潜在的混杂因素。
OSA 的总体患病率为 32.2%，与较高的母体 BMI、分娩时的体重以及孕期体重增加显著相关（p=0.007、p=0.003、p=0.005）。根据筛查的 OSA 阳性，无论肥胖分层如何，主要结局均无显著差异。OSA 阳性组的剖宫产率明显较高（36.0% vs. 22.5%，p=0.018），但肥胖分层中无显著差异。在多变量分析中，出生体重、子痫前期、剖宫产和小于胎龄儿的结局也与 OSA 的阳性无关。
似乎通过睡眠问卷评估的 OSA 患病率过高，高估了韩国孕妇的 OSA 患病率。可能需要进行多导睡眠图以诊断 OSA 并评估 OSA 与 SGA 或子痫前期发生之间的关系。
