Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; National Institute on Drug Dependence, Peking University, Beijing, China; Department of Addiction, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China.
Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; National Institute on Drug Dependence, Peking University, Beijing, China.
Sleep Med. 2018 Dec;52:67-74. doi: 10.1016/j.sleep.2018.07.021. Epub 2018 Aug 22.
Sleep is critical for glucose metabolism. Pregnant women often have sleep disturbances and extreme sleep duration. Investigations of the relationship between sleep duration during pregnancy and gestational diabetes mellitus (GDM) have reported inconsistent results. The present study aimed to meta-analyze the relationship between sleep duration during pregnancy and GDM risk.
We performed a systematic search of the PubMed, ISI Web of Science, and PsycINFO databases for studies that were published up to October 2017, that reported associations between sleep duration during pregnancy and GDM risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as the effect sizes for all studies. Heterogeneity and potential publication biases were assessed.
A total of 4366 papers were retrieved, among which seven studies assessed the relationship between sleep duration during pregnancy and GDM development. The seven articles included 18,203 subjects at baseline and 1294 GDM cases during follow-up. Compared to normal sleep duration, extreme sleep duration during early and middle pregnant stages had a close relationship with GDM based upon pooled data from prospective and cross-sectional studies. Prospective results showed that long sleep duration during pregnancy was a risk factor for GDM, but not short sleep duration. Publication biases were found when analyzing the relationship between extreme sleep duration and GDM.
Extreme sleep duration during pregnancy is closely associated with GDM. Moreover, long but not short sleep duration can predict the risk of developing GDM. These findings remind us of the importance of sleep duration control during pregnancy and help optimize early strategies for the prevention of GDM.
睡眠对葡萄糖代谢至关重要。孕妇常出现睡眠障碍和睡眠时间极端变化。关于妊娠期睡眠时间与妊娠期糖尿病（GDM）之间关系的研究结果报道不一。本研究旨在对妊娠期睡眠时间与 GDM 风险之间的关系进行荟萃分析。
我们系统地检索了 PubMed、ISI Web of Science 和 PsycINFO 数据库，以获取截至 2017 年 10 月发表的研究报告，这些研究报告报道了妊娠期睡眠时间与 GDM 风险之间的关联。所有研究均采用比值比（OR）和 95%置信区间（CI）作为效应量。评估了异质性和潜在的发表偏倚。
共检索到 4366 篇论文，其中 7 篇研究评估了妊娠期睡眠时间与 GDM 发展之间的关系。这 7 篇文章在基线时纳入了 18203 例受试者，随访期间发生了 1294 例 GDM 病例。基于前瞻性和横断面研究的汇总数据，与正常睡眠时间相比，妊娠早期和中期的极端睡眠时间与 GDM 密切相关。前瞻性研究结果表明，怀孕期间长睡眠时间是 GDM 的危险因素，但短睡眠时间不是。当分析极端睡眠时间与 GDM 之间的关系时，发现了发表偏倚。
妊娠期极端睡眠时间与 GDM 密切相关。此外，长睡眠时间而非短睡眠时间可预测 GDM 的发病风险。这些发现提醒我们妊娠期睡眠时间控制的重要性，并有助于优化预防 GDM 的早期策略。
