Bourjeily Ghada, Butterfield Kristen, Curran Patrizia, Lambert-Messerlian Geralyn
Warren Alpert Medical School of Brown University , Providence, RI , USA .
J Matern Fetal Neonatal Med. 2015 Feb;28(3):262-6. doi: 10.3109/14767058.2014.913131. Epub 2014 May 14.
Obstructive sleep apnea (OSA) has been associated with adverse fetal outcomes in some studies. Second trimester Down syndrome screening markers reflect fetal and fetoplacental wellbeing. We aimed to compare markers of fetal and feto-placental wellbeing in women with OSA and low risk controls.
A retrospective case-control study of pregnant women with OSA and available second trimester markers was performed. Controls were screened for sleep disordered breathing (SDB) at the time of delivery using a questionnaire. Women at low risk for OSA were selected. Marker levels were adjusted for gestational age and race and reported as multiples of median and later adjusted for body mass index (BMI).
Twenty-four OSA cases and 166 controls were identified. Women with OSA had a higher mean BMI when compared to controls (37.1 ± 12.7 versus 24.1 ± 5.1, p = 0.03). Estriol (uE3) multiples of the median (MoM) levels were lower in women with OSA compared to controls, even after adjusting for BMI, 0.74 (interquartile range (IQR) 0.45) versus 1.06 (IQR 0.38), respectively, p = 0.026. Once adjusted for BMI, alpha feto-protein (AFP) MoM levels were no longer significantly different in women with OSA compared to controls.
OSA is associated with reduced serum uE3 levels, independently of BMI, possibly indicating fetal distress.
在一些研究中，阻塞性睡眠呼吸暂停（OSA）与不良胎儿结局有关。孕中期唐氏综合征筛查标志物反映胎儿及胎儿-胎盘的健康状况。我们旨在比较患有OSA的女性与低风险对照组中胎儿及胎儿-胎盘健康状况的标志物。
对患有OSA且有可用孕中期标志物的孕妇进行了一项回顾性病例对照研究。对照组在分娩时使用问卷筛查睡眠呼吸障碍（SDB）。选择OSA低风险的女性。标志物水平根据孕周和种族进行调整，并报告为中位数倍数，随后再根据体重指数（BMI）进行调整。
确定了24例OSA病例和166例对照。与对照组相比，患有OSA的女性平均BMI更高（37.1±12.7对24.1±5.1，p = 0.03）。即使在调整BMI后，患有OSA的女性的雌三醇（uE3）中位数倍数（MoM）水平仍低于对照组，分别为0.74（四分位间距（IQR）0.45）对1.06（IQR 0.38），p = 0.026。一旦调整BMI，患有OSA的女性与对照组相比，甲胎蛋白（AFP）MoM水平不再有显著差异。
OSA与血清uE3水平降低有关，独立于BMI，这可能表明胎儿窘迫。
