Departamento de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil,
Departamento de Medicina, Centro Universitário Christus, Fortaleza, CE, Brasil.
Arch Endocrinol Metab. 2023 Jan 18;67(1):92-100. doi: 10.20945/2359-3997000000515. Epub 2022 Sep 20.
This study aims to evaluate the impact of morning-evening preference in pregnancy outcomes in gestational diabetes mellitus (GDM).
This is a prospective cohort study of 2nd-3rd trimester GDM outpatient care in Fortaleza, Brazil (2018-2020). Eveningness was defined by the Horne-Östberg Morningness-Eveningness-Questionnaire (MEQ ≤ 41). Furthermore, we obtained a 7-day actigraphic register. Subjective sleep quality, daytime somnolence, insomnia, fatigue and depressive symptoms were also evaluated. Associations with pregnancy outcomes were investigated.
Among 305 patients with GDM, evening preference was found in 21 (6.9%). Patients with evening preference had worse sleep quality (p < 0.01), greater severity of insomnia (p < 0.005), fatigue (p < 0.005) and depressive symptoms (<0.009). Evening chronotype was associated with preeclampsia [p = 0.01; OR = 0.27; CI 0.09-0.79] and a greater need for admission to a neonatal intensive care unit (NICU) [p = 0.02; OR = 0.23; CI .0.06-0.80]. A lower MEQ score confirmed an association with preeclampsia [p = 0.002; OR = 0.94; CI 0.90-0.97] and this was maintained after controlling for age, arterial hypertension, sleep quality, fatigue and depressive symptoms [p < 005; OR = 0.91; CI 0.87-0.95].
In GDM, patients with evening preference had worse sleep quality, more insomnia, fatigue, and depressive symptoms. Furthermore, eveningness was independently associated with preeclampsia. These results indicate the important role of eveningness in adverse pregnancy outcomes.
本研究旨在评估晨-晚间偏好对妊娠期糖尿病（GDM）妊娠结局的影响。
这是一项在巴西福塔莱萨进行的 2 至 3 期 GDM 门诊护理的前瞻性队列研究（2018-2020 年）。通过 Horne-Ostberg 晨-晚间问卷（MEQ≤41）定义为晚型。此外，我们还获得了 7 天的活动记录仪记录。还评估了主观睡眠质量、日间嗜睡、失眠、疲劳和抑郁症状。调查了这些因素与妊娠结局的关联。
在 305 名 GDM 患者中，发现 21 名（6.9%）患者有晚型偏好。晚型偏好患者的睡眠质量更差（p<0.01），失眠严重程度更高（p<0.005）、疲劳（p<0.005）和抑郁症状更严重（p<0.009）。夜间型与子痫前期有关（p=0.01；OR=0.27；CI 0.09-0.79），并需要更多地入住新生儿重症监护病房（NICU）（p=0.02；OR=0.23；CI 0.06-0.80）。MEQ 得分较低与子痫前期有关（p=0.002；OR=0.94；CI 0.90-0.97），并且在控制年龄、动脉高血压、睡眠质量、疲劳和抑郁症状后仍保持关联（p<0.05；OR=0.91；CI 0.87-0.95）。
在 GDM 中，晚型偏好患者的睡眠质量更差，失眠、疲劳和抑郁症状更多。此外，晚型与子痫前期独立相关。这些结果表明，晚型在不良妊娠结局中起着重要作用。
