妊娠期阻塞性睡眠呼吸暂停筛查问卷的性能：系统评价和荟萃分析。
Performance of screening questionnaires for obstructive sleep apnea during pregnancy: A systematic review and meta-analysis.
机构信息
Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Ramathibodi Hospital Sleep Disorder Center and Division of Pulmonary and Critical Care, Medicine Department, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Sleep Med Rev. 2017 Dec;36:96-106. doi: 10.1016/j.smrv.2016.11.003. Epub 2016 Nov 15.
This review aims to evaluate the performance of obstructive sleep apnea (OSA) screening questionnaires during pregnancy. A systematic review and meta-analysis was performed using MEDLINE Scopus, CINAHL, and the Cochrane library. A bivariate meta-analysis was applied for pooling of diagnostic parameters. Six of the total 4719 articles met the inclusion criteria. The Berlin questionnaire (BQ, N = 604) and Epworth sleepiness scale (ESS, N = 420) were the most frequently used screening tools during pregnancy. The pooled prevalence of OSA during pregnancy was 26.7% (95%CI: 16.9%, 34.4%, I = 83.15%). BQ performance was poor to fair with pooled sensitivity and specificity of 0.66 (95%CI: 0.45, 0.83; I = 78.65%) and 0.62 (95%CI: 0.48, 0.75; I = 81.55%), respectively. BQ performance was heterogeneous depending on type of reference test and pregnancy. Sensitivity increased if diagnosis was based on polysomnography (0.90), and respiratory disturbance index (0.90). However, sensitivity decreased if screening was performed in early pregnancy (≤20 weeks gestation: 0.47), and high-risk pregnancy (0.44). Performance of ESS was poor with pooled sensitivity and specificity of 0.44 (95%CI: 0.33, 0.56; I = 32.8%) and 0.62 (95%CI: 0.48, 0.75; I = 81.55%), respectively. In conclusion, BQ and ESS showed poor performance during pregnancy, hence a new OSA screening questionnaire is needed. Registration: PROSPERO registration CRD42015025848.
这篇综述旨在评估阻塞性睡眠呼吸暂停（OSA）筛查问卷在妊娠期间的性能。通过 MEDLINE Scopus、CINAHL 和 Cochrane 图书馆进行了系统综述和荟萃分析。采用双变量荟萃分析对诊断参数进行汇总。在总共 4719 篇文章中，有 6 篇符合纳入标准。柏林问卷（BQ，N=604）和爱泼沃斯嗜睡量表（ESS，N=420）是妊娠期间最常用的筛查工具。妊娠期间 OSA 的总体患病率为 26.7%（95%CI：16.9%，34.4%，I=83.15%）。BQ 的表现为差到尚可，其汇总敏感性和特异性分别为 0.66（95%CI：0.45，0.83；I=78.65%）和 0.62（95%CI：0.48，0.75；I=81.55%）。BQ 的性能取决于参考测试和妊娠类型而异。如果诊断基于多导睡眠图（0.90）和呼吸干扰指数（0.90），则敏感性增加。然而，如果筛查在妊娠早期（≤20 周妊娠：0.47）和高危妊娠（0.44）进行，则敏感性降低。ESS 的性能较差，汇总敏感性和特异性分别为 0.44（95%CI：0.33，0.56；I=32.8%）和 0.62（95%CI：0.48，0.75；I=81.55%）。总之，BQ 和 ESS 在妊娠期间表现不佳，因此需要一种新的 OSA 筛查问卷。注册：PROSPERO 注册 CRD42015025848。
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