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超重和肥胖孕妇患阻塞性睡眠呼吸暂停及其他睡眠障碍的风险较高。

High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women.

作者信息

Rice Jayne R, Larrabure-Torrealva Gloria T, Luque Fernandez Miguel Angel, Grande Mirtha, Motta Vicky, Barrios Yasmin V, Sanchez Sixto, Gelaye Bizu, Williams Michelle A

机构信息

Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA.

Instituto Nacional Materno Perinatal de Lima, Lima, Peru.

出版信息

BMC Pregnancy Childbirth. 2015 Sep 2;15:198. doi: 10.1186/s12884-015-0633-x.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries.

METHODS

We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru. The Berlin questionnaire was used to identify women at high risk for OSA. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to examine sleep quality and excessive daytime sleepiness, respectively. Multinomial logistic regression procedures were employed to estimate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for putative confounding factors.

RESULTS

Compared with lean women (<25 kg/m(2)), overweight women (25-29.9 kg/m(2)) had 3.69-fold higher odds of high risk for OSA (95% CI 1.82-7.50). The corresponding aOR for obese women (≥30 kg/m(2)) was 13.23 (95% CI: 6.25-28.01). Obese women, as compared with their lean counterparts had a 1.61-fold higher odds of poor sleep quality (95% CI: 1.00-2.63).

CONCLUSION

Overweight or obese pregnant women have increased odds of sleep disorders, particularly OSA. OSA screening and risk management may be indicated among pregnant women in low and middle income countries, particularly those undergoing rapid epidemiologic transitions characterized by increased prevalence of excessive adult weight gain.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)是一种常见且严重的疾病,睡眠期间呼吸会反复停止,与超重和肥胖有关。关于低收入和中等收入国家孕妇中OSA的共病情况知之甚少。

方法

我们调查了秘鲁利马1032名孕妇孕前超重或肥胖状况与OSA高风险、睡眠质量差和白天过度嗜睡之间的关联程度。使用柏林问卷来识别OSA高风险女性。匹兹堡睡眠质量指数(PSQI)和爱泼华嗜睡量表(ESS)分别用于检查睡眠质量和白天过度嗜睡情况。采用多项逻辑回归程序来估计经假定混杂因素调整后的比值比(aOR)和95%置信区间(CI)。

结果

与体重正常的女性(<25kg/m²)相比,超重女性(25 - 29.9kg/m²)患OSA高风险的几率高3.69倍(95%CI 1.82 - 7.50)。肥胖女性(≥30kg/m²)的相应aOR为13.23(95%CI:6.25 - 28.01)。与体重正常的女性相比,肥胖女性睡眠质量差的几率高1.61倍(95%CI:1.00 - 2.63)。

结论

超重或肥胖的孕妇出现睡眠障碍的几率增加,尤其是OSA。在低收入和中等收入国家的孕妇中,尤其是那些经历以成人超重患病率增加为特征的快速流行病学转变的孕妇中,可能需要进行OSA筛查和风险管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d7/4557601/fd274dc0fa14/12884_2015_633_Fig1_HTML.jpg

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