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Sleep disordered breathing in pregnancy: Prevalence and outcomes at delivery.

機(jī)譯：孕婦睡眠呼吸紊亂：分娩時(shí)的患病率和結(jié)局。

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Introduction Sleep Disordered Breathing (SDB) during pregnancy is associated with maternal and neonatal morbidity, and in-hospital mortality. A recent prevalence study using the Nationwide Inpatient Sample reported an obstructive sleep apnea (OSA) prevalence of 7.3 per 10,000 in 2013, a rate of 24% per year over the last decade. The rise in prevalence mirrors the rise in obesity. Military Treatment Facilities (MTF) have seen an increase in obesity and related co-morbidities with an unknown prevalence of SDB. Most studies have been conducted in high-risk populations; the general prevalence of SDB and its association with adverse pregnancy outcomes in a military population needs exploration.;Methods This prospective, observational study used the Facco Four Variable (FFV) model and STOP-Bang to screen parturients presenting for delivery at a MTF to determine the general prevalence of SDB. Logistic regression on parturient data who screened positive, FFV (score ≥75) and STOP-Bang (score ≥ 3) was used to examine if higher rates of adverse pregnancy outcomes (gestational hypertension, preeclampsia/eclampsia, gestational diabetes, non-elective cesarean delivery, NICU admission, hospital stay >5 days, a composite variable of adverse pregnancy outcomes) were associated with SDB. Demographic and prevalence data were compared between active duty and non-active duty participants.;Results Of the study population (N=295), the FFV identified 12.3% (n=36) and STOP-Bang 7.1% (n=21) participants at high risk for SDB. Adverse pregnancy outcomes were experienced by 58% women with the FFV and 66% with STOP-Bang. Logistic regression indicated the FFV categorical score (?75) was not predictive of adverse pregnancy outcomes. Utilizing FFV absolute score, an increased risk of APO was noted (adjusted OR=1.03, 95% CI 1.01-1.05, p=.013). Logistic regression indicated a STOP-Bang score ?3 was predictive of an adverse pregnancy outcome (adjusted OR=3.26, 95% CI 1.23-8.62, p=.018).;Conclusion Findings support the need for routine screening for identification of SDB during pregnancy and the opportunity for repeated testing to track progression, treatment, and resolution of SDB. Further research is needed to determine critical points in the development and management of SDB during pregnancy, if and when SDB resolves after delivery, and the long-term health effects for both mother and child.
機(jī)譯：簡(jiǎn)介懷孕期間的睡眠呼吸障礙（SDB）與母親和新生兒的發(fā)病率以及院內(nèi)死亡率相關(guān)。最近使用全國(guó)住院患者樣本進(jìn)行的患病率研究報(bào)告稱，2013年阻塞性睡眠呼吸暫停（OSA）患病率為7.3 / 10,000，在過(guò)去十年中每年以24％的速度增長(zhǎng)?；疾÷噬仙从沉朔逝职Y的上升。軍事治療機(jī)構(gòu)（MTF）肥胖癥和相關(guān)合并癥的發(fā)病率有所增加，而SDB的患病率未知。大多數(shù)研究是在高風(fēng)險(xiǎn)人群中進(jìn)行的。方法：本前瞻性觀察性研究使用了Facco四變量（FFV）模型和STOP-Bang篩選了要在MTF分娩的產(chǎn)婦，以確定SDB的普遍流行。對(duì)篩查陽(yáng)性，F(xiàn)FV（≥75）和STOP-Bang（≥3）的分娩數(shù)據(jù)進(jìn)行邏輯回歸分析，以檢查不良妊娠結(jié)局（妊娠高血壓，先兆子癇/子癇，妊娠糖尿病，非選擇性剖宮產(chǎn)）是否更高分娩，新生兒重癥監(jiān)護(hù)病房（NICU）入院，住院時(shí)間超過(guò)5天，不良妊娠結(jié)局的綜合變量）與SDB相關(guān)。結(jié)果比較了現(xiàn)役人員和非現(xiàn)役人員的人口統(tǒng)計(jì)學(xué)和患病率。結(jié)果：在研究人群中（N = 295），F(xiàn)FV識(shí)別出12.3％（n = 36）和STOP-Bang 7.1％（n = 21）參與者深發(fā)展的高風(fēng)險(xiǎn)。 58％的FFV婦女和66％的STOP-Bang婦女經(jīng)歷了不良的妊娠結(jié)局。 Logistic回歸表明FFV類別評(píng)分（？75）不能預(yù)測(cè)不良妊娠結(jié)局。利用FFV絕對(duì)評(píng)分，發(fā)現(xiàn)APO的風(fēng)險(xiǎn)增加（校正OR = 1.03，95％CI 1.01-1.05，p = .013）。 Logistic回歸表明STOP-Bang得分≥3可預(yù)示不良妊娠結(jié)局（校正后OR = 3.26，95％CI 1.23-8.62，p = .018）。結(jié)論結(jié)論在進(jìn)行期間，需要常規(guī)篩查以鑒定SDB懷孕以及重復(fù)測(cè)試以追蹤SDB的進(jìn)展，治療和消退的機(jī)會(huì)。尚需進(jìn)一步研究以確定妊娠期SDB的發(fā)展和管理中的關(guān)鍵點(diǎn)，分娩后SDB是否及何時(shí)消退，以及對(duì)母嬰的長(zhǎng)期健康影響。

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  • 作者

    Nations, Ryan L.;

  • 作者單位

    University of San Diego.;

  • 授予單位 University of San Diego.;
  • 學(xué)科 Nursing.;Obstetrics.
  • 學(xué)位 Ph.D.
  • 年度 2015
  • 頁(yè)碼 91 p.
  • 總頁(yè)數(shù) 91
  • 原文格式 PDF
  • 正文語(yǔ)種 eng
  • 中圖分類
  • 關(guān)鍵詞

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