Shao Shuyi, Shuai Zhenhong, Qin Chunrong, Shao Jiejie, Chen Chunqin, Song Minmin, Li Xuemei, Zhao Huanqiang
Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China.
Women and Children's Medical Center, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China.
J Obstet Gynaecol. 2025 Dec;45(1):2516605. doi: 10.1080/01443615.2025.2516605. Epub 2025 Jun 18.
The aims of this study are to investigate the causal relationships between sleep traits and the risk of gestational diabetes mellitus (GDM), preterm birth, and foetal growth restriction (FGR).
This two-sample Mendelian Randomisation (MR) study was conducted from May to June 2024 to investigate the associations between seven sleep traits and GDM, preterm birth, and FGR. The study utilised data from large-scale genome-wide association study datasets, and specifically focused on individuals of European descent. The main analysis employed inverse-variance-weighted MR, with sensitivity analyses conducted to mitigate potential pleiotropy-induced biases. Additionally, multivariable MR analysis was conducted to adjust for potential confounding factors.
Genetically predicted excessive daytime sleepiness (OR 13.67; 95% CI, 1.03-180.59; = 0.047) and sleep apnoea (OR 1.29; 95% CI, 1.00-1.65; = 0.049) were found to be associated with a higher risk of GDM. No sleep trait was associated with either preterm birth or FGR. These results were robust across various sensitivity analyses. In the multivariable MR analysis, adjusting for body mass index (BMI) and smoking, the genetically instrumented excessive daytime sleepiness (OR 14.58; 95% CI 1.67-127.36; = 0.015) and sleep apnoea (OR 1.30; 95% CI 1.02-1.64; = 0.030) were consistently associated with an increased GDM risk.
This study suggests a causal relationship between both excessive daytime sleepiness and sleep apnoea to the development of GDM. Excessive daytime sleepiness and sleep apnoea demonstrate promise as potentially preventable risk factors for GDM.
本研究旨在探讨睡眠特征与妊娠期糖尿病（GDM）、早产和胎儿生长受限（FGR）风险之间的因果关系。
这项两样本孟德尔随机化（MR）研究于2024年5月至6月进行，以调查七种睡眠特征与GDM、早产和FGR之间的关联。该研究利用了大规模全基因组关联研究数据集的数据，特别关注欧洲血统的个体。主要分析采用逆方差加权MR，并进行敏感性分析以减轻潜在的多效性引起的偏差。此外，进行多变量MR分析以调整潜在的混杂因素。
发现遗传预测的白天过度嗜睡（OR 13.67；95%CI，1.03 - 180.59；P = 0.047）和睡眠呼吸暂停（OR 1.29；95%CI，1.00 - 1.65；P = 0.049）与GDM风险较高相关。没有睡眠特征与早产或FGR相关。这些结果在各种敏感性分析中都很稳健。在多变量MR分析中，调整体重指数（BMI）和吸烟因素后，遗传工具化的白天过度嗜睡（OR 14.58；95%CI 1.67 - 127.36；P = 0.015）和睡眠呼吸暂停（OR 1.30；95%CI 1.02 - 1.64；P = 0.030）始终与GDM风险增加相关。
本研究表明白天过度嗜睡和睡眠呼吸暂停与GDM的发生之间存在因果关系。白天过度嗜睡和睡眠呼吸暂停有望成为GDM潜在的可预防风险因素。
