La Verde Marco, Marrapodi Maria Maddalena, Palma Marica, Pisani Davide, Russo Diana, Ronsivalle Vincenzo, Cicciù Marco, Minervini Giuseppe
Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
J Sleep Res. 2025 Aug;34(4):e14460. doi: 10.1111/jsr.14460. Epub 2025 Jan 15.
Literature evidenced an association of maternal sleep disturbances and maternal obstructive sleep apnea with significant obstetric complications. Moreover, the maternal sleep disturbances effect on feto-placental circulation had not been extensively examined. Our objective is to explore the possible maternal sleep disturbances impact on the feto-placental indices evaluated through the Doppler study. A systematic review of the following databases was performed: PubMed, EMBASE, Cochrane Library and Google Scholar from the beginning to June 2024. Only studies that enrolled pregnant women with signs and symptoms of maternal sleep disturbances or obstructive sleep apnea diagnosis, which analysed the feto-placental Doppler parameters, were considered eligible (PROSPERO ID: CRD42024553926). We included a total of four studies with 1715 cases of pregnant women. Various instrumental and non-instrumental diagnostic methods were adopted for detection of maternal sleep disturbances. The ultrasound exam was performed mainly in the third trimester of pregnancies, and all the studies explored the uterine Doppler parameters. Only two studies explore the foetal Doppler parameters. Only one study disclosed that maternal sleep disturbances are related to altered uterine Doppler indices with probable placental dysfunction. This review did not evidence a significant influence of maternal sleep disturbances and obstructive sleep apnea on foetal Doppler indices. Moreover, one large prospective study showed a possible impact of maternal sleep disturbances on uterine Doppler with a potential impairment of the placentation function. Additional studies with detailed data and larger samples are needed to throw light on this relationship and its impact on the foetal outcomes.
文献表明，孕妇睡眠障碍和孕妇阻塞性睡眠呼吸暂停与严重的产科并发症有关。此外，孕妇睡眠障碍对胎儿 - 胎盘循环的影响尚未得到广泛研究。我们的目的是探讨孕妇睡眠障碍可能对通过多普勒研究评估的胎儿 - 胎盘指标产生的影响。我们对以下数据库进行了系统综述：从开始到2024年6月的PubMed、EMBASE、Cochrane图书馆和谷歌学术。只有纳入有孕妇睡眠障碍体征和症状或阻塞性睡眠呼吸暂停诊断的孕妇，且分析了胎儿 - 胎盘多普勒参数的研究才被认为符合条件（PROSPERO编号：CRD42024553926）。我们总共纳入了四项研究，涉及1715例孕妇。采用了各种仪器和非仪器诊断方法来检测孕妇睡眠障碍。超声检查主要在妊娠晚期进行，所有研究都探讨了子宫多普勒参数。只有两项研究探讨了胎儿多普勒参数。只有一项研究表明，孕妇睡眠障碍与子宫多普勒指数改变及可能的胎盘功能障碍有关。本综述未证明孕妇睡眠障碍和阻塞性睡眠呼吸暂停对胎儿多普勒指数有显著影响。此外，一项大型前瞻性研究表明，孕妇睡眠障碍可能对子宫多普勒有影响，并可能损害胎盘形成功能。需要更多有详细数据和更大样本量的研究来阐明这种关系及其对胎儿结局的影响。
