孕早期睡眠问题。一项在普通科门诊接受产前保健的孕妇中进行的横断面研究。
Sleep complaints in early pregnancy. A cross-sectional study among women attending prenatal care in general practice.
机构信息
Research Unit for General Practice and Section for General Practice, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014, Copenhagen K, Denmark.
出版信息
BMC Pregnancy Childbirth. 2020 Feb 22;20(1):123. doi: 10.1186/s12884-020-2813-6.
BACKGROUND
Sleep problems in late pregnancy are common, but sleep in early pregnancy is less well described. The aim of this study was to describe the occurrence and severity of sleep complaints in early pregnancy. We asked the women about worries due to sleep problems. Furthermore, we investigated the associations between sleep complaints and pregnancy-related symptoms. This association was studied taking into account physical and mental health, sociodemographic characteristics, and reproductive history of the women.
METHODS
Cross-sectional study in Danish general practice based on an electronic questionnaire completed by pregnant women and a Pregnancy Health Record filled in by the general practitioner (GP). The questionnaire measured three sleep complaints and 11 common physical pregnancy-related symptoms. The sleep complaints were measured as mild, moderate or severe, and it was recorded how much they worried the women. The associations between the physical pregnancy-related symptoms and sleep complaints were assessed by odds ratios from multivariable logistic regression models.
RESULTS
The questionnaire was completed by 1338 out of 1508 eligible women before the end of gestation week 16. The gestational age ranged from 5 to 16 weeks (median 11 weeks) among the included women. On average, more than one third of the women reported to have at least one of the three sleep complaints in the questionnaire. Problems "taking a long time to fall asleep" was reported by 312 women (23%), "waking up too early" was reported by 629 (47%), and 183 (14%) had been "lying awake most of the night". One sleep complaint was reported by 38%, two by 16, and 4% had all three symptoms. The majority were not at all or only mildly worried because of their sleep disturbances, but moderate or severe worries were found among 46% of those" taking a long time to fall asleep" and among 40% of those "lying awake most of the night". "Moderate or severe complaints" were reported by 277 (21%) women "Moderate or severe complaints" were associated with pregnancy-related physical symptoms, such as back pain, pelvic girdle pain and pelvic cavity pain, but only the association with pelvic cavity pain stayed significant after adjustment for depression.
CONCLUSION
This study showed that sleep complaints in early pregnancy are common, and sleep complaints showed association with physical as well as mental symptoms. It may be important for pregnant patients that clinicians address depression, and mood in relation to sleep problems during pregnancy.
背景
妊娠晚期睡眠问题很常见，但妊娠早期的睡眠情况描述较少。本研究旨在描述妊娠早期睡眠问题的发生和严重程度。我们询问了女性因睡眠问题而产生的担忧。此外，我们还研究了睡眠问题与妊娠相关症状之间的关系。考虑到女性的身心健康、社会人口特征和生育史，研究了这种关联。
方法
基于丹麦普通实践中的电子问卷进行的横断面研究，该问卷由孕妇填写，由全科医生（GP）填写妊娠健康记录。该问卷测量了三种睡眠问题和 11 种常见的与妊娠相关的身体症状。睡眠问题被测量为轻度、中度或重度，并记录了这些问题给女性带来的困扰程度。使用多变量逻辑回归模型评估与睡眠问题相关的与妊娠相关的身体症状之间的关联。
结果
在妊娠 16 周末之前，共有 1508 名符合条件的女性中有 1338 名完成了问卷。纳入女性的孕周范围为 5 至 16 周（中位数为 11 周）。平均而言，超过三分之一的女性在问卷中报告了至少一种三种睡眠问题中的一种。312 名女性（23%）报告“入睡时间长”，629 名（47%）报告“早醒”，183 名（14%）“整夜大部分时间都醒着”。38%的女性报告了一种睡眠问题，16%的女性报告了两种，4%的女性报告了三种。由于睡眠障碍，大多数女性根本不担心或只轻度担心，但有 46%的“入睡时间长”和 40%的“整夜大部分时间都醒着”的女性表示中度或重度担忧。277 名女性（21%）报告“中度或重度抱怨”。“中度或重度抱怨”与妊娠相关的身体症状相关，如背痛、骨盆带疼痛和盆腔疼痛，但仅与盆腔疼痛的关联在调整抑郁后仍然显著。
结论
本研究表明，妊娠早期的睡眠问题很常见，睡眠问题与身体和心理症状有关。临床医生在怀孕期间解决抑郁和与睡眠问题相关的情绪问题，可能对孕妇很重要。
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