Lucchini Maristella, Rayport Yael, Valeri Linda, Jelic Sanja, St-Onge Marie-Pierre, O'Brien Louise M, Alcantara Carmela
Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.
Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA.
Obesity (Silver Spring). 2023 Apr;31(4):923-933. doi: 10.1002/oby.23697. Epub 2023 Mar 2.
The aim of this study was to assess the prevalence and severity of sleep-disordered breathing (SDB) across racial/ethnic groups in 3702 pregnant people at 6 to 15 and 22 to 31 weeks gestational age, examine whether BMI modifies the association between race/ethnicity and SDB, and investigate whether interventions to reduce weight might reduce racial/ethnic disparities in SDB.
Differences by race/ethnicity in SDB prevalence and severity were quantified via linear, logistic, or quasi-Poisson regression. Controlled direct effect was used to estimate whether intervening on BMI would remove/diminish differences by race/ethnicity in SDB severity.
This study comprised 61.2% non-Hispanic White (nHW), 11.9% non-Hispanic Black (nHB), 18.5% Hispanic, and 3.7% Asian people. SDB prevalence was higher for nHB compared with nHW pregnant people at 6 to 15 weeks (odds ratio [OR] 1.81, 95% CI [1.07, 2.97]), whereas at 21 to 32 weeks, Asian pregnant people had a higher SDB prevalence than nHW (OR 2.2, 95% CI [1.1, 4.0]). The severity of SDB differed across racial/ethnic groups in early pregnancy, with nHB pregnant people having a higher apnea-hypopnea index (AHI) (OR 1.35, 95% CI [1.07, 1.69]) compared with nHW. Having overweight/obesity was associated with a higher AHI (β = 2.36, 95% CI [1.97, 2.84]). Controlled direct effect analyses indicated that in early pregnancy, nHB and Hispanic pregnant people would have a lower AHI compared with nHW people had they had normal weight.
This study extends knowledge on racial/ethnic disparities in SDB to a pregnant population.
本研究旨在评估3702名孕周为6至15周以及22至31周的孕妇中不同种族/族裔群体睡眠呼吸障碍（SDB）的患病率和严重程度，研究体重指数（BMI）是否会改变种族/族裔与SDB之间的关联，并调查减轻体重的干预措施是否可能减少SDB中的种族/族裔差异。
通过线性、逻辑或拟泊松回归对不同种族/族裔在SDB患病率和严重程度方面的差异进行量化。使用受控直接效应来估计干预BMI是否会消除/减少不同种族/族裔在SDB严重程度方面的差异。
本研究包括61.2%的非西班牙裔白人（nHW）、11.9%的非西班牙裔黑人（nHB）、18.5%的西班牙裔和3.7%的亚洲人。在6至15周时，nHB孕妇的SDB患病率高于nHW孕妇（优势比[OR]1.81，95%置信区间[CI][1.07，2.97]），而在21至32周时，亚洲孕妇的SDB患病率高于nHW孕妇（OR 2.2，95%CI[1.1，4.0]）。妊娠早期不同种族/族裔群体的SDB严重程度存在差异，与nHW孕妇相比，nHB孕妇的呼吸暂停低通气指数（AHI）更高（OR 1.35，95%CI[1.07，1.69]）。超重/肥胖与较高的AHI相关（β=2.36，95%CI[1.97，2.84]）。受控直接效应分析表明，在妊娠早期，如果nHB和西班牙裔孕妇体重正常，其AHI将低于nHW孕妇。
本研究将关于SDB种族/族裔差异的知识扩展到了孕妇群体。
