| 摘要: |
| ［摘要］ 目的 探讨中晚期妊娠阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对母儿结局影响。方法 对2020年3月至2021年3月广西医科大学附属柳州市工人医院收治的156例孕妇进行呼吸睡眠障碍筛查，42例孕妇患OSAHS为OSAHS组，114例孕妇未患OSAHS为非OSAHS组。比较两组孕妇临床特征及母儿结局。结果 两组中有高血压病史、糖尿病病史、甲状腺功能减退、OSAHS家族史的人数比例差异均无统计学意义（P>0.05）。孕妇不同预产期年龄组（<25岁、25～34岁、≥35岁）中OSAHS患病率分别为16.7%、23.7%、38.9%，呈上升趋势。在孕中期和孕晚期OSAHS患病率随BMI的增长亦呈上升趋势。OSAHS组中妊娠期高血压疾病、妊娠期糖尿病发生率（分别为47.6%、47.6%）显著高于非OSAHS组（分别为8.8%、29.8%）（P<0.05）。两组胎儿生长受限、羊水过少、死产或死胎、早产、剖宫产、产后出血发生率比较差异无统计学意义（P>0.05）。OSAHS组低出生体重儿发生率（28.6%）高于非OSAHS组（8.8%）（P<0.05）。两组新生儿窒息发生率比较差异无统计学意义（P>0.05）。结论 妊娠期OSAHS患病率随孕妇BMI水平增加而上升。妊娠期OSAHS与妊娠期高血压疾病、妊娠期糖尿病、低出生体重儿的发生密切相关。应加强孕期OSAHS知识的宣教以及筛查，指导患者改变生活方式，必要时给予医疗干预以改善孕期OSAHS情况。 |
| 关键词: 阻塞性睡眠呼吸暂停 母儿结局 妊娠期高血压疾病 妊娠期糖尿病 |
| DOI：10.3969/j.issn.1674-3806.2023.02.14 |
| 分类号:R 714.25 |
| 基金项目:广西卫生健康委科研课题（编号：Z20190911） |
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| Effects of obstructive sleep apnea hypopnea syndrome on maternal and infant outcomes in the pregnant women in the second and third trimesters |
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ZHANG Li-min, LIU Li, YANG Jin-li
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Department of Obstetrics, Liuzhou Worker′s Hospital Affiliated to Guangxi Medical University, Liuzhou 545005, China
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| Abstract: |
| ［Abstract］ Objective To explore the effects of obstructive sleep apnea hypopnea syndrome(OSAHS) on maternal and infant outcomes in the pregnant women in the second and third trimesters. Methods One hundred and fifty-six pregnant women who were admitted to Liuzhou Worker′s Hospital Affiliated to Guangxi Medical University from March 2020 to March 2021 were screened for respiratory and sleep disorders, and according to the screened results, the pregnant women were assigned into the OSAHS group(n=42) and the non-OSAHS group(n=114). The clinical characteristics, maternal and infant outcomes were compared between the two groups. Results There was no significant difference in the proportion of the patients with a history of hypertension, a history of diabetes, hypothyroidism and family history of OSAHS(P>0.05). The prevalence rates of OSAHS in the pregnant women of different age groups(<25 years old, 25-34 years old and ≥35 years old) at the expected delivery periods were 16.7%, 23.7% and 38.9%, respectively, showing an upward trend. The prevalence rate of OSAHS increased with the increase of body mass index(BMI) in the second and third trimesters of pregnancy. The incidence rates of hypertensive disorder complicating pregnancy(HDCP) in the third trimester, gestational diabetes mellitus(GDM) in the OSAHS group(47.6% and 47.6%, respectively) were significantly higher than those in the non-OSAHS group(8.8% and 29.8%, respectively)(P<0.05), and there were no significant differences in the incidence rates of fetal growth restriction(FGR), oligohydramnios, stillbirth or stillborn foetus, preterm birth, cesarean section and postpartum hemorrhage between the two groups(P>0.05). The incidence of low birth weight infants in the OSAHS group(28.6%) was higher than that in the non-OSAHS group(8.8%)(P<0.05). There was no significant difference in the incidence rate of neonatal asphyxia between the two groups(P>0.05). Conclusion With the increase of BMI level, the prevalence of OSAHS during pregnancy increases gradually. OSAHS of pregnant women is closely related to the occurrence of HDCP, GDM and low birth weight infants. Therefore, the knowledge of dissemination and screening about OSAHS during pregnancy should be strengthened, and the OSAHS during pregnancy should be improved through guiding the life-style changes of the patients and performing medical intervention when necessary. |
| Key words: Obstructive sleep apnea Maternal and infant outcomes Hypertensive disorder complicating pregnancy(HDCP) Gestational diabetes mellitus(GDM) |
