Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina.
Int Anesthesiol Clin. 2022 Apr 1;60(2):59-65. doi: 10.1097/AIA.0000000000000360.
The prevalence of OSA in the low-risk obstetric population is thought to be low; best estimates have been extrapolated from the one available large prospective study and likely range between 3–8%. OSA prevalence in high-risk pregnant women such as those with obesity and chronic hypertension is significantly higher as extrapolated from several smaller prospective studies which have reported a prevalence as high as 37% in obese women. Despite the high prevalence of OSA in high-risk pregnant women, it remains underdiagnosed due to several factors. An emerging body of literature suggests that OSA may also have serious implications for the health of mothers and fetuses during and beyond pregnancy, but there is still no data to determine if OSA treatment mitigates these adverse outcomes. In this review, we will examine this body of literature from the perspective of the anesthesiologist: the association between pregnancy and the development or worsening of OSA; OSA as it relates to adverse maternal and fetal outcomes; antepartum and screening considerations for OSA in pregnant women; and recommendations regarding the peripartum management of OSA.
OSA 在低危产科人群中的患病率被认为较低；最佳估计值是从一项可用的大型前瞻性研究中推断出来的，可能在 3%至 8%之间。在肥胖和慢性高血压等高危孕妇中，OSA 的患病率更高，这是从几项较小的前瞻性研究中推断出来的，这些研究报告肥胖女性的患病率高达 37%。尽管高危孕妇中 OSA 的患病率很高，但由于多种因素，该病仍未得到充分诊断。越来越多的文献表明，OSA 在妊娠期间及之后也可能对母亲和胎儿的健康产生严重影响，但仍没有数据来确定 OSA 治疗是否可以减轻这些不良后果。在这篇综述中，我们将从麻醉师的角度来审视这方面的文献：妊娠与 OSA 的发展或恶化之间的关系；OSA 与不良母婴结局的关系；孕妇 OSA 的产前和筛查注意事项；以及围产期 OSA 管理的建议。
