From the Departments of Anesthesiology.
Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
Anesth Analg. 2018 Nov;127(5):1167-1177. doi: 10.1213/ANE.0000000000003335.
Among obese pregnant women, 15%-20% have obstructive sleep apnea (OSA) and this prevalence increases along with body mass index and in the presence of other comorbidities. Prepregnancy obesity and pregnancy-related weight gain are certainly risk factors for sleep-disordered breathing in pregnancy, but certain physiologic changes of pregnancy may also increase a woman's risk of developing or worsening OSA. While it has been shown that untreated OSA in postmenopausal women is associated with a range of cardiovascular, pulmonary, and metabolic comorbidities, a body of literature is emerging that suggests OSA may also have serious implications for the health of mothers and fetuses during and after pregnancy. In this review, we discuss the following: pregnancy as a vulnerable period for the development or worsening of OSA; the associations between OSA and maternal and fetal outcomes; the current screening modalities for OSA in pregnancy; and current recommendations regarding peripartum management of OSA.
在肥胖的孕妇中，15%-20%患有阻塞性睡眠呼吸暂停（OSA），并且随着体重指数的增加以及存在其他合并症，这种患病率也会增加。孕前肥胖和妊娠相关体重增加无疑是妊娠睡眠呼吸障碍的危险因素，但妊娠的某些生理变化也可能增加女性发生或恶化 OSA 的风险。虽然已经表明，绝经后妇女未经治疗的 OSA 与一系列心血管、肺部和代谢合并症相关，但越来越多的文献表明，OSA 也可能对母亲和胎儿在妊娠期间和之后的健康产生严重影响。在这篇综述中，我们讨论了以下内容：妊娠是 OSA 发展或恶化的脆弱时期；OSA 与母婴结局的关联；妊娠中 OSA 的当前筛查方式；以及关于围产期 OSA 管理的当前建议。
