妊娠期睡眠质量调查及睡眠疾病相关因素分析:一项多中心横断面临床研究  

Sleep quality and sleep disturbances in Chinese pregnant women:a multicenter cross-sectional study

作　　者：张楚珺 粟义佳 陈焱[5] 王治洁[6] 胡三莲 许华俊[1,2,3] 刘玉璞 李馨仪[1,2,3] 朱华明 易红良 关建 滕银成[3,7] 殷善开 Zhang Chujun;Su Yijia;Chen Yan;Wang Zhijie;Hu Sanlian;Xu Huajun;Liu Yupu;Li Xinyi;Zhu Huaming;Yi Hongliang;Guan Jian;Teng Yincheng;Yin Shankai(Department of Otorhinolaryngology Head and Neck Surgery,Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital,Shanghai 200233,China;Otorhinolaryngology Institute of Shanghai Jiao Tong University,Shanghai 200233,China;Shanghai Key Laboratory of Sleep Disordered Breathing,Shanghai 200233,China;Department of Nursing,Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital,Shanghai 200233,China;Department of Obstetrics,the International Peace Maternity and Child Health Hospitals of China Welfare Institution,Shanghai 200233,China;Department of Gynecology and Obstetrics,Shanghai Eighth People′s Hospital,Shanghai 200233,China;Department of Gynecology and Obstetrics,Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院耳鼻咽喉头颈外科,上海200233 [2]上海交通大学耳鼻咽喉研究所,上海200233 [3]上海市睡眠呼吸障碍重点实验室,上海200233 [4]上海交通大学医学院附属第六人民医院护理部,上海200233 [5]中国福利会国际和平妇幼保健院产科,上海200233 [6]上海市第八人民医院妇产科,上海200233 [7]上海交通大学医学院附属第六人民医院妇产科,上海200233

出　　处：《中华耳鼻咽喉头颈外科杂志》2022年第3期308-316,共9页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：上海市科学技术委员会科技创新行动计划项目(16411950104,16411950105,16411950106);上海市科学技术委员会科技创新行动计划(18DZ2260200)。

摘　　要：目的:调查上海徐汇地区妊娠期女性睡眠质量,并分析睡眠呼吸障碍(sleep-disordered breathing,SDB)等睡眠疾病的相关因素。方法:研究采用国际标准化横断面临床研究设计,自2019年2月至2021年2月,在上海交通大学医学院附属第六人民医院、中国福利会国际和平妇幼保健院及上海市第八人民医院使用电子化的整合睡眠问卷[包括匹兹堡睡眠质量指数问卷(Pittsburgh sleep quality index,PSQI)、柏林问卷(Berlin questionnaire,BQ)、爱泼沃斯思睡量表(Epworth sleepiness scale,ESS)、雅典失眠量表(Athens insomnia scale,AIS)]调查妊娠期女性的睡眠质量,收集其人口学信息、生育史、体格检查结果等临床资料。统计夜间睡眠不足/过量、睡眠效率低下、入睡困难、睡眠质量差、失眠、日间过度思睡及睡眠呼吸障碍高风险等多种睡眠疾病在各孕期女性中的患病率,并分析不同睡眠疾病的相关因素。采用SPSS 22.0及OriginLab 2019b软件进行统计学分析与制图。结果:研究纳入孕早期女性1898例,孕中期女性3099例,孕晚期女性1539例。夜间睡眠不足(42例,2.7%),夜间睡眠过量(132例,8.6%),入睡困难(187例,12.2%),睡眠效率低下(542例,35.4%),睡眠质量极差(102例,6.7%),临床失眠(335例,21.8%),SDB高风险(44例,6.4%)的患病率在孕晚期女性中最高(χ2值分别是20.455、6.027、35.565、38.046、15.376、6.782,P值均<0.05)。睡眠质量较差(724例,38.6%),不同程度日间思睡(日间思睡794例,41.9%,日间过度思睡336例,17.7%,有危险性的日间思睡40例,2.1%),可疑失眠(612例,32.3%)的患病率在孕早期女性中最高(χ2值分别是38.046、33.875、15.376,P值均<0.01)。对妊娠期女性而言,较大孕周(OR=1.016)、多次人流或药流史(OR=1.329)是睡眠质量差(PSQI>5)的风险因素,而多次足月产史(OR=0.800)是其保护因素。大龄孕妇(OR=0.976)、多次足月产史(OR=0.808)、较大孕周(OR=0.983)、高血压(OR=0.572)是日间思睡(ESSObjective This study aims to investigate the sleep quality of pregnant women in Xuhui District,Shanghai,and the related factors of sleep disturbances during pregnancy.Methods From February 2019 to February 2021,we used online integrated sleep questionnaire(including PSQI,BQ,ESS,AIS)in Shanghai Jiao Tong University School of Medicine Affiliated Sixth People′s Hospital,The International Peace Maternity and Child Health Hospitals of China Welfare Institution,and Shanghai Eighth People′s Hospital,to investigate the sleep quality across pregnancy.We also collected maternal physical examination results,childbearing history,sociodemographic,and other clinical data.The prevalences and related factors of various sleep disturbances in pregnant women were analyzed,including insufficient/excessive nighttime sleep,low sleep efficiency,difficulty falling asleep,poor sleep quality,insomnia,daytime sleepiness,and high risk of sleep-disordered breathing(SDB).Results This study includes 1898 cases in the first trimester(T1),3099 cases in the second trimester(T2),and 1539 cases in the third trimester(T3).Poor sleep quality(38.6%),daytime sleepiness(mild 41.9%,moderate 17.7%,severe 2.1%),and suspicious insomnia(32.3%)are most prevalent among women in T1(P<0.01).In comparison,short sleep time(2.7%),long sleep time(8.6%),difficulty falling asleep(12.2%),poor sleep efficiency(35.4%),very poor sleep quality(6.7%),clinical insomnia(21.8%),and high-risk SDB(6.4%)are most prevalent among women in T3(P<0.05).During pregnancy,late gestation(OR=1.016,95%CI:1.006-1.025)and multiple induced/drug abortions(OR=1.329,95%CI:1.043-1.692)are risk factors for poor sleep quality(PSQI>5),while multiple full-term deliveries(OR=0.800,95%CI:0.675-0.949)is its protective factor.Advanced maternal age(OR=0.976,95%CI:0.956-0.997),multiple full-term deliveries(OR=0.808,95%CI:0.680-0.959),late gestation(OR=0.983,95%CI:0.974-0.992)and hypertension(OR=0.572,95%CI:0.401-0.814)are protective factors for daytime sleepiness(ESS>6).The high-risk pregnancy category(

关 键 词：妊娠 多中心研究 睡眠质量 睡眠疾病 

分 类 号：R714.2[医药卫生—妇产科学] R740[医药卫生—临床医学]