一种先前经验证的针对睡眠呼吸暂停的妊娠特异性筛查工具在肥胖患病率高的队列中的临床应用。
Clinical application of a previously validated pregnancy-specific screening tool for sleep apnea in a cohort with a high prevalence of obesity.
作者信息
Bajaj Sakshi, Rice A Lauren, White Payden, Wiedmer Abigail M, Jacobson Natalie M, Jones Nathan R, Bazalakova Mihaela H, Antony Kathleen M
机构信息
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Wisconsin-Madison, School of Medicine and Public Health, 1010 Mound Street, Madison, WI, USA.
Department of Biology, University of Wisconsin-Madison, Madison, WI, USA.
出版信息
Sleep Med X. 2023 Jan 8;5:100061. doi: 10.1016/j.sleepx.2023.100061. eCollection 2023 Dec.
OBJECTIVE
The purpose of this project was to determine the positive predictive value of existing obstructive sleep apnea (OSA) screening tools in clinical use, in a real-world clinical population of gravidae, and to explore the development of a new questionnaire for screening for OSA during pregnancy.
METHODS
Pregnant people were administered sleep screening questionnaires as part of routine clinical care. These included Facco's four variable OSA screening tool, the STOP-BANG, and the Epworth Sleepiness Scale. Those who screened positive were referred for diagnostic sleep testing, typically with a type III home monitoring device. Here we analyzed the screening responses used by those who completed diagnostic testing to determine the positive predictive value of the existing tools.
RESULTS
159 pregnant people completed diagnostic OSA testing and were included in this analysis. The positive predictive value of Facco's four variable sleep screening tool was 74.3%, STOP-BANG was 75.3%, and the Epworth Sleepiness Scale was 69.8%. Our sample size was insufficient to create a new screening tool.
CONCLUSIONS
Here we calculated the positive predictive value of Facco's 4 variable screening tool for screening for OSA in pregnancy in a real-world pregnant population. While we were not able to generate a new screening tool for screening for OSA during pregnancy, both STOP-BANG and Facco's four variable tool had positive predictive values over 70% in our population which was characterized by high BMI and advanced maternal age. Increased clinical use of the pregnancy-specific tool may be warranted.
目的
本项目旨在确定临床使用的现有阻塞性睡眠呼吸暂停（OSA）筛查工具在真实世界临床孕妇群体中的阳性预测值，并探索开发一种用于孕期OSA筛查的新问卷。
方法
作为常规临床护理的一部分，对孕妇进行睡眠筛查问卷评估。这些问卷包括法科（Facco）的四变量OSA筛查工具、STOP-BANG问卷和爱泼华嗜睡量表。筛查呈阳性的孕妇被转介进行诊断性睡眠测试，通常使用III型家庭监测设备。在此，我们分析了完成诊断测试者的筛查反应，以确定现有工具的阳性预测值。
结果
159名孕妇完成了OSA诊断测试并纳入本分析。法科的四变量睡眠筛查工具的阳性预测值为74.3%，STOP-BANG问卷为75.3%，爱泼华嗜睡量表为69.8%。我们的样本量不足以创建一种新的筛查工具。
结论
在此，我们计算了法科的四变量筛查工具在真实世界孕妇群体中筛查孕期OSA的阳性预测值。虽然我们未能生成一种用于孕期OSA筛查的新筛查工具，但在以高体重指数和高龄产妇为特征的我们的人群中，STOP-BANG问卷和法科的四变量工具的阳性预测值均超过70%。可能有必要增加针对特定孕期的工具的临床应用。
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