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非西班牙裔黑人孕妇的睡眠障碍负担。

Burden of sleep disturbance in non-Hispanic Black pregnant women.

机构信息

Department of Epidemiology, School of Public Health, Emory University, Atlanta, Georgia.

Division of Sleep Medicine, Department of Neurology, Michigan Medicine, Ann Arbor, Michigan.

出版信息

J Clin Sleep Med. 2022 May 1;18(5):1319-1325. doi: 10.5664/jcsm.9854.

Abstract

STUDY OBJECTIVES

Non-Hispanic Black pregnant women disproportionately experience poor perinatal outcomes compared to other racial/ethnic groups. Sleep disruption has emerged as a risk factor for adverse pregnancy outcomes, but there are limited data in minority pregnant women. We examined the prevalence of habitual snoring and its timing of onset with several key sleep-wake disturbances and their associations with perinatal outcomes in a cohort of non-Hispanic Black pregnant women.

METHODS

Non-Hispanic Black pregnant women in their third trimester were recruited from a large academic medical center and screened for habitual snoring and its timing relative to pregnancy, along with sleep quality, symptoms of insomnia, excessive daytime sleepiness, and daytime function. Clinical diagnoses of hypertensive disorders of pregnancy were obtained along with delivery outcomes.

RESULTS

In 235 women, the vast majority (80%) reported 3 or more sleep-wake disturbances, and almost half had at least 5 disturbances. Sixteen percent reported prepregnancy snoring and 20% reported pregnancy-onset snoring. Women with pregnancy-onset snoring had significantly increased odds of poor sleep quality (adjusted odds ratio [aOR] = 8.2), trouble staying asleep (aOR = 3.6), waking up too early (aOR = 2.7), excessive daytime sleepiness (aOR = 2.3), and poor daytime function (aOR = 8.7) but no relationship with perinatal outcomes. In contrast, prepregnancy snoring was related to chronic hypertension, preterm delivery, and fetal growth restriction (aOR = 2.6, aOR = 2.8, and aOR = 5.1, respectively).

CONCLUSIONS

Sleep-wake disturbances confer a significant burden to pregnant non-Hispanic Black women, an infrequently studied yet disproportionately affected population. Contributions of maternal sleep to racial disparities in perinatal health should be a priority for public health research.

CITATION

White KM, Dunietz GL, Pitts DS, Kalmbach DA, Lucchini M, O'Brien LM. Burden of sleep disturbance in non-Hispanic Black pregnant women. 2022;18(5):1319-1325.

摘要

研究目的

与其他种族/族裔群体相比,非西班牙裔黑人孕妇的围产期结局较差,不成比例。睡眠障碍已成为不良妊娠结局的一个风险因素,但在少数族裔孕妇中数据有限。我们研究了非西班牙裔黑人孕妇中习惯性打鼾的流行率及其与几种关键的睡眠-觉醒障碍的发病时间及其与围产期结局的关系。

方法

从一家大型学术医疗中心招募了处于妊娠晚期的非西班牙裔黑人孕妇,并对其进行了习惯性打鼾及其与妊娠相对时间的筛查,同时还评估了睡眠质量、失眠症状、日间嗜睡和日间功能。还获得了妊娠高血压疾病的临床诊断和分娩结局。

结果

在 235 名女性中,绝大多数(80%)报告有 3 种或更多种睡眠-觉醒障碍,近一半有至少 5 种障碍。16%的人报告有孕前打鼾,20%的人报告有孕后打鼾。有孕后打鼾的女性睡眠质量差的可能性显著增加(调整后的优势比[aOR] = 8.2),入睡困难(aOR = 3.6),早醒(aOR = 2.7),日间嗜睡(aOR = 2.3),日间功能差(aOR = 8.7),但与围产期结局无关。相比之下,孕前打鼾与慢性高血压、早产和胎儿生长受限有关(aOR = 2.6,aOR = 2.8 和 aOR = 5.1)。

结论

睡眠-觉醒障碍给怀孕的非西班牙裔黑人女性带来了重大负担,而这一人群的研究却很少,受影响的程度却不成比例。产妇睡眠对围产期健康种族差异的影响应该成为公共卫生研究的重点。

引文

White KM、Dunietz GL、Pitts DS、Kalmbach DA、Lucchini M、O'Brien LM。非西班牙裔黑人孕妇睡眠障碍的负担。2022;18(5):1319-1325。

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本文引用的文献

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