Tang Wei-Zhen, Huang Kang-Jin, Xu Hong-Yu, Cai Qin-Yu, Song Ying-Ping, Fan Tian-Qi, Zhang Yao, Liu Tai-Hang, Li Ying-Bo
Department of Bioinformatics, School of Basic Medical Sciences, Chongqing Medical University, No.1 Yixueyuan Rd, Box 197, Chongqing, 400016, China.
The Joint International Research Laboratory of Reproduction and Development, Chongqing Medical University, Chongqing, 400016, China.
Reprod Biol Endocrinol. 2025 Aug 2;23(1):114. doi: 10.1186/s12958-025-01431-x.
Obstructive sleep apnea (OSA) has long been recognized as a significant risk factor for hypertension, and in recent years, its association with hypertensive disorders of pregnancy (HDP) has gained increasing attention, especially in the unique population of pregnant women. However, this relationship remains underappreciated in clinical practice. While early studies have suggested a link between OSA and adverse pregnancy outcomes, the mechanisms connecting OSA to HDP are not fully understood. This literature review explores potential pathways, including intermittent hypoxia, oxidative stress, systemic inflammation, dysregulation of the sympathetic nervous system, endothelial dysfunction, and atherosclerosis. It also examines current treatments, especially CPAP therapy, and its variable effectiveness in managing HDP symptoms, as well as potential alternatives such as throat strengthening exercises and external hypoglossal stimulation. Future research should focus on improving OSA screening during pregnancy, developing better diagnostic tools, and integrating routine OSA evaluations in prenatal care for early intervention. Clarifying the mechanisms linking OSA and HDP will help refine treatment strategies. Large-scale, randomized controlled trials are needed to assess the efficacy of combination therapies and develop evidence-based clinical guidelines.
阻塞性睡眠呼吸暂停（OSA）长期以来一直被认为是高血压的一个重要危险因素，近年来，其与妊娠高血压疾病（HDP）的关联越来越受到关注，尤其是在孕妇这一特殊人群中。然而，这种关系在临床实践中仍未得到充分重视。虽然早期研究表明OSA与不良妊娠结局之间存在联系，但OSA与HDP之间的关联机制尚未完全明确。这篇文献综述探讨了潜在的途径，包括间歇性缺氧、氧化应激、全身炎症、交感神经系统失调、内皮功能障碍和动脉粥样硬化。它还研究了当前的治疗方法，特别是持续气道正压通气（CPAP）治疗及其在管理HDP症状方面的不同效果，以及潜在的替代方法，如咽喉强化锻炼和舌下神经外部刺激。未来的研究应专注于改善孕期OSA筛查、开发更好的诊断工具，并将常规OSA评估纳入产前护理以进行早期干预。阐明OSA与HDP之间的关联机制将有助于完善治疗策略。需要进行大规模的随机对照试验来评估联合治疗的疗效并制定基于证据的临床指南。
