University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA, USA.
RTI International, Research Triangle Park, NC, USA.
Sleep Med. 2021 May;81:312-318. doi: 10.1016/j.sleep.2021.02.043. Epub 2021 Feb 27.
Sleep-disordered breathing (SDB) in pregnancy is associated with adverse maternal outcomes. The relationship between SDB and infant birthweight is unclear. This study's primary aim is to determine if objectively measured SDB in pregnancy is associated with infant birthweight.
We measured SDB objectively in early (6-15 weeks' gestation) and mid (22-31 weeks' gestation) pregnancy in a large cohort of nulliparous women. SDB was defined as an Apnea-Hypopnea Index ≥5 and in secondary analyses we also examined measures of nocturnal hypoxemia. We used a modified Poisson regression approach to estimate relative risks (RR) of large-for-gestational-age (LGA: >90th percentile for gestational age) and small-for-gestational-age (SGA: <10th percentile for gestational age) birthweights.
The prevalence of early-pregnancy SDB was nearly 4%. The incidence of mid-pregnancy SDB was nearly 6.0%. The prevalence of LGA and SGA was 7.4% and 11.9%, respectively. Early-pregnancy SDB was associated with a higher risk of LGA in unadjusted models (RR 2.2, 95% CI 1.3-3.5) but not BMI-adjusted models (aRR 1.0, 95% CI 0.6-1.8). Mid-pregnancy SDB was not associated with SGA or LGA. Mid-pregnancy nocturnal hypoxemia (% of sleep time <90% oxygen saturation) and increasing nocturnal hypoxemia from early to mid-pregnancy were associated with a higher risk of LGA in BMI-adjusted models. SDB and nocturnal hypoxemia were not associated with SGA.
SDB in pregnancy was not associated with an increased risk of LGA or SGA birthweight, independent of BMI. Some measures nocturnal hypoxemia were associated with an increase in LGA risk, independent of BMI. ClinicalTrials.gov Registration number NCT02231398.
妊娠睡眠呼吸障碍（SDB）与不良母婴结局有关。SDB 与婴儿出生体重的关系尚不清楚。本研究的主要目的是确定妊娠时客观测量的 SDB 是否与婴儿出生体重有关。
我们在大量初产妇的早孕期（6-15 孕周）和中孕期（22-31 孕周）对 SDB 进行了客观测量。SDB 定义为呼吸暂停低通气指数（Apnea-Hypopnea Index，AHI）≥5，在二次分析中，我们还检查了夜间低氧血症的指标。我们使用修正泊松回归方法来估计大于胎龄儿（LGA：大于胎龄的第 90 百分位数）和小于胎龄儿（SGA：小于胎龄的第 10 百分位数）出生体重的相对风险（RR）。
早孕期 SDB 的患病率接近 4%。中孕期 SDB 的发生率接近 6.0%。LGA 和 SGA 的患病率分别为 7.4%和 11.9%。未校正模型中，早孕期 SDB 与 LGA 风险增加相关（RR 2.2，95%CI 1.3-3.5），但校正 BMI 后无相关性（aRR 1.0，95%CI 0.6-1.8）。中孕期 SDB 与 SGA 或 LGA 无关。中孕期夜间低氧血症（睡眠时间＜90%氧饱和度的百分比）和从中孕期到早孕期夜间低氧血症的增加与校正 BMI 后的 LGA 风险增加相关。SDB 和夜间低氧血症与 SGA 无关。
妊娠时的 SDB 与 LGA 或 SGA 出生体重增加无关，与 BMI 无关。一些夜间低氧血症指标与 LGA 风险增加有关，与 BMI 无关。ClinicalTrials.gov 注册号：NCT02231398。
