Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Phathumwan, Bangkok, 10330, Thailand.
Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Phathumwan, Bangkok, 10330, Thailand.
Sleep Breath. 2019 Jun;23(2):687-693. doi: 10.1007/s11325-018-1758-8. Epub 2018 Nov 27.
Preeclampsia-eclampsia remains one of the leading causes of maternal and perinatal morbidity and mortality. Emerging evidence suggests that obstructive sleep apnea (OSA), which has been linked to hypertension in the general population, may play role in hypertensive disorders in pregnancy, including preeclampsia-eclampsia. However, little research has been conducted in Asia (no data in Thailand) on the effects of OSA on preeclampsia-eclampsia. We aimed to examine the association between OSA and preeclampsia-eclampsia among Thai pregnant women.
We conducted a large prospective cohort study among Thai pregnant women who were in the second trimester of singleton pregnancy. The Berlin Questionnaire was administered to evaluate the risk for OSA. Preeclampsia-eclampsia was diagnosed by standard clinical assessment. Multivariate models were applied in adjustment for confounding factors.
Enrolled were 1345 pregnant women. The overall prevalence of high risk for OSA was 10.1% (95% confidence intervals [CIs] 8.5-11.7), and it was significantly associated with pre-pregnancy body mass index and score on the Perceived Stress Scale. An adjusted odds ratio (OR) for preeclampsia-eclampsia in women with high risk for OSA was 2.72 (95% CI 1.33-5.57).
Pregnant women with high risk for OSA are at increased risks for preeclampsia-eclampsia compared to those with low risk for OSA. Our results support a role for screening for OSA by BQ during antenatal care.
子痫前期-子痫仍然是导致孕产妇和围产儿发病率和死亡率的主要原因之一。新出现的证据表明，阻塞性睡眠呼吸暂停（OSA）与普通人群中的高血压有关，它可能在妊娠高血压疾病中发挥作用，包括子痫前期-子痫。然而，亚洲（泰国无数据）对 OSA 对子痫前期-子痫的影响的研究甚少。我们旨在研究泰国孕妇中 OSA 与子痫前期-子痫之间的关联。
我们对处于单胎妊娠中期的泰国孕妇进行了一项大型前瞻性队列研究。采用柏林问卷评估 OSA 的风险。通过标准临床评估诊断子痫前期-子痫。多变量模型用于调整混杂因素。
共纳入 1345 名孕妇。高危 OSA 的总体患病率为 10.1%（95%置信区间[CI] 8.5-11.7），与孕前体重指数和感知压力量表评分显著相关。高危 OSA 孕妇子痫前期-子痫的调整比值比（OR）为 2.72（95%CI 1.33-5.57）。
与低危 OSA 孕妇相比，高危 OSA 孕妇发生子痫前期-子痫的风险增加。我们的结果支持在产前保健期间通过 BQ 筛查 OSA。
