Spence Dennis L, Allen Rhonda C, Lutgendorf Monica A, Gary Virginia R, Richard John D, Gonzalez Sara C
Department of Anesthesiology, Naval Medical Center San Diego, San Diego, CA, United States; Clinical Investigation Department, Naval Medical Center San Diego, San Diego, CA, United States.
Clinical Investigation Department, Naval Medical Center San Diego, San Diego, CA, United States.
Eur J Obstet Gynecol Reprod Biol. 2017 Mar;210:166-172. doi: 10.1016/j.ejogrb.2016.12.013. Epub 2016 Dec 14.
Obstructive sleep apnea (OSA) is associated with significant morbidity and mortality in non-obstetrical and obstetrical patients.
To estimate the prevalence of OSA and its relationship with pregnancy-related complications in a general obstetric population of Department of Defense beneficiaries receiving direct-care at military treatment facilities.
A retrospective cohort study of all women (N=305,001) who gave birth at a military treatment facility from 2008 to 2014. OSA cases were randomly selected and matched on age (3:1 ratio) to non OSA cases. Multivariable logistic regression was used to examine the risks of adverse pregnancy outcomes (cesarean delivery, gestational diabetes, gestational hypertension, preeclampsia, postoperative wound complications, hospital stay greater than five days, acute renal failure, pulmonary edema, preterm delivery, poor fetal growth, and stillbirth) between pregnant women with and without a diagnosis of OSA. Cases were identified using ICD-9 codes, while controlling for demographics, obesity, and medical comorbidities associated with OSA and the outcomes of interest.
We identified 266 cases of OSA (OSA rate=8.7 per 10,000; increased from 6.4 to 9.9 per 10,000 from 2009 to 2013). OSA was associated with a higher odds of cesarean delivery (AOR,1.60; 95% CI, 1.06-2.40), gestational hypertension, (AOR, 2.46; 95% CI, 1.30-4.68), preeclampsia (AOR, 2.42; 95% CI, 1.43-4.09), and preterm delivery (AOR, 1.90; 95% CI, 1.09-3.30).
Obstructive sleep apnea is associated with adverse maternal and fetal outcomes.
阻塞性睡眠呼吸暂停（OSA）与非产科和产科患者的显著发病率和死亡率相关。
评估在军事治疗机构接受直接护理的国防部受益人的普通产科人群中OSA的患病率及其与妊娠相关并发症的关系。
对2008年至2014年在军事治疗机构分娩的所有女性（N = 305,001）进行回顾性队列研究。随机选择OSA病例，并按年龄（3:1比例）与非OSA病例进行匹配。使用多变量逻辑回归来检查诊断为OSA和未诊断为OSA的孕妇之间不良妊娠结局（剖宫产、妊娠期糖尿病、妊娠高血压、先兆子痫、术后伤口并发症、住院时间超过五天、急性肾衰竭、肺水肿、早产、胎儿生长受限和死产）的风险。使用国际疾病分类第九版（ICD - 9）编码识别病例，同时控制人口统计学、肥胖以及与OSA和感兴趣结局相关的合并症。
我们识别出266例OSA病例（OSA患病率 = 每10,000人中有8.7例；从2009年到2013年从每10,000人中有6.4例增加到9.9例）。OSA与剖宫产几率较高（调整后比值比[AOR]，1.60；95%置信区间[CI]，1.06 - 2.40）、妊娠高血压（AOR，2.46；95% CI，1.30 - 4.68）、先兆子痫（AOR，2.42；95% CI，1.43 - 4.09）和早产（AOR，1.90；95% CI，1.09 - 3.30）相关。
阻塞性睡眠呼吸暂停与不良的母婴结局相关。
