妊娠期糖尿病与睡眠呼吸紊乱。

Gestational diabetes mellitus and sleep-disordered breathing.

机构信息

Department of Pediatrics, Centre hospitalier universitaire de Québec, the Research Centre, Institut universitaire de cardiologie et pneumologie de Québec, and the Departments of Medical Biology and Endocrinology, CHU de Québec, Université Laval, Quebec City, and the Sleep Laboratory, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada.

出版信息

Obstet Gynecol. 2014 Mar;123(3):634-641. doi: 10.1097/AOG.0000000000000143.

DOI:10.1097/AOG.0000000000000143

PMID:24499765

Abstract

OBJECTIVE

To examine the link between gestational diabetes mellitus (GDM) and sleep-disordered breathing using complete polysomnography and questionnaires in a case-control study of pregnant women.

METHODS

Pregnant women (body mass index [BMI] less than 35, no prior diabetes or hypertension) were eligible as cases (n=26) if diagnosed with GDM by routine 75-g oral glucose tolerance test. Women in the control group without GDM (n=26) were matched for gestational age at polysomnography, BMI, and age. Polysomnography were conducted at home at 24-32 weeks of gestation. Sleepiness score (Epworth Sleepiness Scale), subjective sleep quality (Pittsburgh Sleep Quality Index), risk for depression (Edinburgh Postnatal Depression Scale), and restless legs syndrome were assessed by questionnaire.

RESULTS

Primary outcome apnea-hypopnea index (4.2±3.9 events per hour in women in the case group compared with 3.8±2.3 events per hour in women in the control group) as well as other objective and subjective sleep measures, including oxygen desaturation index, snoring, and flow limitation, were not significantly different between groups. Sleepiness was greater in women in the case group than in women in the control group (9.8±3.6 compared with 7.2±3.6, P=.05). Additionally, 23% of women in the case group compared with 0% of women in the control group (P<.01) reported an Edinburgh Scale score of at least 10 (suggesting significant depression) and 46% of women with GDM reported restless legs syndrome compared to 19% of women in the control group (P=.07).

CONCLUSION

There was no association between GDM and sleep-disordered breathing in pregnant women with prepregnancy BMIs under 35 and no medical comorbidities.

摘要

目的

通过对孕妇的病例对照研究，使用完整的多导睡眠图和问卷来研究妊娠期糖尿病（GDM）与睡眠呼吸紊乱之间的关系。

方法

如果孕妇通过常规的 75 克口服葡萄糖耐量试验被诊断为 GDM，则符合病例组的条件（n=26）。GDM 组的孕妇（BMI<35，无既往糖尿病或高血压）与在多导睡眠图检查时的孕龄、BMI 和年龄相匹配的无 GDM 的对照组孕妇（n=26）。多导睡眠图在妊娠 24-32 周时在家中进行。通过问卷评估嗜睡评分（Epworth 嗜睡量表）、主观睡眠质量（匹兹堡睡眠质量指数）、抑郁风险（爱丁堡产后抑郁量表）和不安腿综合征。

结果

主要结局为呼吸暂停低通气指数（病例组的女性为 4.2±3.9 次/小时，对照组的女性为 3.8±2.3 次/小时）以及其他客观和主观睡眠测量指标，包括氧减指数、打鼾和流量受限，两组之间无显著差异。病例组的女性比对照组的女性嗜睡程度更高（9.8±3.6 与 7.2±3.6，P=.05）。此外，与对照组的女性（0%）相比，病例组的女性中，有 23%（P<.01）报告的爱丁堡量表评分至少为 10（提示有明显的抑郁），有 46%的 GDM 女性报告有不安腿综合征，而对照组的女性为 19%（P=.07）。