Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.
Maternal and Child Health Center of Gulou District, Nanjing, China.
Sleep Breath. 2023 Aug;27(4):1557-1565. doi: 10.1007/s11325-022-02748-2. Epub 2022 Nov 22.
This study aimed to demonstrate the relationship between poor sleep quality in early pregnancy and the risk of developing gestational diabetes mellitus (GDM).
We conducted a nested case-control study and performed a 1:3 propensity score (PS) matching to match pregnant women with GDM to women without GDM. After PS matching, logistic regressions were carried out to describe the association between sleep quality (assessed by Pittsburgh Sleep Quality Index [PSQI]) and the risk of GDM. We also performed a second analysis to explore the association in groups divided according to maternal age.
A total of 535 women were enrolled in this study. Of 456 women with complete data, the incidence of GDM was 12.1% (55/456). After PS matching, we found poor sleep quality (PSQI > 5) in early pregnancy was a statistically significant risk factor for GDM (OR 2.03; 95% CI 1.02-4.01; p-value = 0.043). The association of poor sleep quality (PSQI > 5) with GDM was significant among women less than 35 years old (OR 2.72; 95% CI 1.22-6.43; p-value = 0.018) but not among women more than or equal to 35 years old after adjusting for all covariates.
Poor sleep quality in early pregnancy is associated with higher risk of developing GDM, especially for women under 35 years old. Screening expectant mothers with sleep problems in the first trimester is suggested.
本研究旨在探讨孕早期睡眠质量差与妊娠期糖尿病(GDM)发病风险之间的关系。
我们进行了一项巢式病例对照研究,并进行了 1:3 的倾向评分(PS)匹配,以将患有 GDM 的孕妇与未患有 GDM 的孕妇进行匹配。PS 匹配后,我们采用逻辑回归来描述睡眠质量(用匹兹堡睡眠质量指数[PSQI]评估)与 GDM 发病风险之间的关系。我们还进行了第二次分析,以探索根据产妇年龄分组的关联。
共有 535 名女性参与了本研究。在 456 名数据完整的女性中,GDM 的发病率为 12.1%(55/456)。经 PS 匹配后,我们发现孕早期睡眠质量差(PSQI>5)是 GDM 的一个统计学上显著的危险因素(OR 2.03;95%CI 1.02-4.01;p 值=0.043)。在调整了所有协变量后,睡眠质量差(PSQI>5)与 GDM 的关联在年龄小于 35 岁的女性中更为显著(OR 2.72;95%CI 1.22-6.43;p 值=0.018),但在年龄大于或等于 35 岁的女性中并不显著。
孕早期睡眠质量差与发生 GDM 的风险增加相关,尤其是对于年龄小于 35 岁的女性。建议在孕早期筛查有睡眠问题的孕妇。