Alonso-Fernández Alberto, Ribot Quetglas Caterina, Herranz Mochales Andrea, Álvarez Ruiz De Larrinaga Ainhoa, Sánchez Barón Andrés, Rodríguez Rodríguez Paula, Gil Gómez Ana Victoria, Pía Martínez Carla, Cubero Marín José Pablo, Barceló Nicolau Maria, Cerdà Moncadas María, Codina Marcet Mercedes, De La Peña Bravo Mónica, Barceló Bennasar Antònia, Iglesias Coma Amanda, Morell-Garcia Daniel, Peña Zarza José Antonio, Giménez Carrero María Paloma, Durán Cantolla Joaquín, Marín Trigo José María, Piñas Cebrian María Concepción, Soriano Joan B, García-Río Francisco
Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain.
Servicio de Neumología, Hospital Universitari Son Espases, Palma, Spain.
Front Med (Lausanne). 2021 Nov 2;8:674997. doi: 10.3389/fmed.2021.674997. eCollection 2021.
Obstructive sleep apnea (OSA) is prevalent in pregnancy and it is associated with adverse pregnancy-related outcomes such as gestational diabetes, pre-eclampsia, and low birth weight. Maternal systemic inflammation is proposed to be one of the main intermediate mechanisms. However, the effects of OSA on systemic inflammation are unknown in normal pregnancy. Women in the 3rd trimester underwent hospital polysomnography to evaluate whether OSA increases systemic inflammation in normal pregnancy and its potential association with adverse fetal outcomes. OSA was defined as an apnea-hypopnea index (AHI) of ≥ 5 h. Plasma cytokines levels (TNF-α, IL-1β, IL-6, IL-8, and IL-10) were determined by multiple immunoassays. We included 11 patients with OSA and 22 women with AHI < 5 h, who were homogeneous in age, and body mass index (BMI). Women with OSA had significant higher levels of TNF-α, IL-1β, IL-8, and IL-10. We found significant correlations between AHI during REM and TNF-α ( = 0.40), IL-1β ( = 0.36), IL-6 ( = 0.52), IL-8 ( = 0.43), between obstructive apnea index and TNF-α ( = 0.46) and between AHI and IL-1β ( = 0.43). We also found that CT90% was related to IL-8 ( = 0.37). There were no significant differences in neonatal characteristics; however, we found inverse correlations between TNF-α and IL-8 with birth weight (both = -0.48), while IL-8 showed a significant inverse relationship with neonatal gestational age ( = -0.48). OSA in our normal pregnancy population was associated with higher systemic inflammation, which was related to obstructive events, especially during REM sleep. Moreover, systemic inflammation was inversely correlated with neonatal birth weight and age.
阻塞性睡眠呼吸暂停（OSA）在孕期很常见，且与不良妊娠相关结局有关，如妊娠期糖尿病、先兆子痫和低出生体重。母体全身炎症被认为是主要的中间机制之一。然而，在正常妊娠中，OSA对全身炎症的影响尚不清楚。孕晚期女性接受了医院多导睡眠监测，以评估OSA是否会增加正常妊娠中的全身炎症及其与不良胎儿结局的潜在关联。OSA被定义为呼吸暂停低通气指数（AHI）≥5次/小时。通过多种免疫测定法测定血浆细胞因子水平（TNF-α、IL-1β、IL-6、IL-8和IL-10）。我们纳入了11例OSA患者和22例AHI<5次/小时的女性，她们在年龄和体重指数（BMI）方面具有同质性。OSA女性的TNF-α、IL-1β、IL-8和IL-10水平显著更高。我们发现快速眼动期AHI与TNF-α（r = 0.40）、IL-1β（r = 0.36）、IL-6（r = 0.52）、IL-8（r = 0.43）之间，阻塞性呼吸暂停指数与TNF-α（r = 0.46）之间，以及AHI与IL-1β（r = 0.43）之间存在显著相关性。我们还发现CT90%与IL-8相关（r = 0.37）。新生儿特征方面没有显著差异；然而，我们发现TNF-α和IL-8与出生体重呈负相关（r均为-0.48），而IL-8与新生儿胎龄呈显著负相关（r = -0.48）。我们正常妊娠人群中的OSA与更高的全身炎症相关，这与阻塞性事件有关，尤其是在快速眼动睡眠期间。此外，全身炎症与新生儿出生体重和年龄呈负相关。
