Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia.
Mater Mothers' Hospital, Brisbane, Queensland, Australia.
Aust N Z J Obstet Gynaecol. 2020 Dec;60(6):877-883. doi: 10.1111/ajo.13166. Epub 2020 May 5.
Snoring, gasping or choking during sleep are common symptoms of sleep-disordered breathing and are associated with multiple adverse maternal and obstetric outcomes. The mechanisms responsible remain unknown; however, placental dysfunction is suspected.
The aim of this study was to investigate feto-placental and fetal cardiac function in women with pregnancies complicated by obstructive sleep apnoea symptoms.
This was a prospective observational cohort study at a large tertiary obstetric hospital in Australia. Women were asked to complete a questionnaire relating to the presence and severity of obstructive sleep apnoea symptoms. They also underwent an ultrasound scan where Doppler indices of various feto-placental vessels and fetal cardiac function were measured. Regional cerebral perfusion was also assessed.
A total of 255 women were included in the final analysis. Of these, 36.1% (92/255) of women reported no obstructive sleep apnoea symptoms; 63.9% (163/255) reported they experienced some form of obstructive sleep apnoea symptoms that included any frequency of snoring or choking/gasping, while 42.0% (107/255) complained of severe obstructive sleep apnoea symptoms (snoring ≥ 3 times a week or choking/gasping). There were no significant differences in feto-placental Dopplers or fetal cardiac function parameters in women with obstructive sleep apnoea symptoms. There were also no differences in regional cerebral blood flow between groups, or any correlation with severity of symptoms.
Our data challenge the current perspective that adverse perinatal outcomes in women with obstructive sleep apnoea symptoms are related primarily to placental dysfunction and fetal compromise.
睡眠中打鼾、喘气或窒息是睡眠呼吸紊乱的常见症状,与多种不良母婴和产科结局相关。其相关机制尚不清楚;然而,胎盘功能障碍被怀疑与此相关。
本研究旨在探讨合并阻塞性睡眠呼吸暂停症状的妊娠女性的胎-胎盘和胎儿心功能。
这是在澳大利亚一家大型三级产科医院进行的前瞻性观察性队列研究。要求女性填写一份问卷,内容涉及阻塞性睡眠呼吸暂停症状的存在和严重程度。她们还接受了超声检查,测量了各种胎-胎盘血管和胎儿心功能的多普勒指数。还评估了局部脑灌注。
共有 255 名女性纳入最终分析。其中,36.1%(92/255)的女性报告没有阻塞性睡眠呼吸暂停症状;63.9%(163/255)的女性报告存在某种形式的阻塞性睡眠呼吸暂停症状,包括打鼾或窒息/喘气的任何频率,而 42.0%(107/255)的女性抱怨严重的阻塞性睡眠呼吸暂停症状(每周打鼾≥3 次或窒息/喘气)。有阻塞性睡眠呼吸暂停症状的女性的胎-胎盘多普勒或胎儿心功能参数没有显著差异。各组之间的局部脑血流量也没有差异,与症状严重程度也没有相关性。
我们的数据挑战了当前的观点,即阻塞性睡眠呼吸暂停症状女性的不良围产期结局主要与胎盘功能障碍和胎儿受损有关。