妊娠早期和中期睡眠质量的特点分析  

Analysis of characteristics of sleep quality in early and middle pregnancy

作　　者：宋伟[1] 王雪昕 刘静[1] 郑媛媛[1] 孙成娟[1] 刘野[3] 高磊[1] 梁胜男 程冬梅 赵晟隆[1] 范辰辰 闫慧慧 时青云 赵友萍[1] 丁新[1] 王小轶[4] 刘晓巍[1] Song Wei;Wang Xuexin;Liu Jing;Zheng Yuanyuan;Sun Chengjuan;Liu Ye;Gao Lei;Liang Shengnan;Cheng Dongmei;Zhao Shenglong;Fan Chenchen;Yan Huihui;Shi Qingyun;Zhao Youping;Ding Xin;Gao Hong;Wang Xiaoyi;Liu Xiaowei(Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital.Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院北京妇幼保健院围产医学部,100026 [2]首都医科大学附属北京妇产医院北京妇幼保健院内科,100026 [3]首都医科大学附属北京妇产医院北京妇幼保健院麻醉科,100026 [4]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科、耳鼻咽喉头颈科学教育部重点实验室

出　　处：《北京医学》2023年第5期398-403,共6页Beijing Medical Journal

基　　金：北京市属医院科研培育项目(PX2020058);首都医科大学附属北京妇产医院中青年学科骨干培养专项(FCYY202003)。

摘　　要：目的探讨妊娠早期和中期孕妇睡眠质量的特点。方法选取2020年9月至2022年3月首都医科大学附属北京妇产医院进行产检、且接受便携式睡眠呼吸监测的妊娠早期和中期的单胎妊娠孕妇177例,根据孕周分为孕早期组(孕周≤13^(+6)周,108例)、孕中期组(14^(+0)周≤孕周≤27^(+6)周,69例),分析和比较两组睡眠质量相关指标的特点和差异。结果177例孕妇中位年龄33.8(31.1,36.7)岁,孕前体质指数(pre-pregnancy BMI,PPBMI)中位数为28.1(25.8,30.1)kg/m^(2),孕周中位数为12.0(10.0,16.0)周。与孕早期相比,孕中期的PPBMI更低、睡眠潜伏期更长(N2潜伏期、N3潜伏期)、睡眠效率更低、非快速动眼期EEG觉醒指数及呼吸觉醒指数更低、低通气最大时长更短,差异均有统计学意义(P<0.05)。41.2%的孕妇存在至少一种以上的睡眠质量问题,包括睡眠效率低(21.5%,38/177)、睡眠潜伏期延长(16.9%,30/177)、睡眠片段化(10.2%,18/177)和睡眠时间缩短(5.6%,10/177)。孕中期睡眠潜伏期延长的风险显著高于孕早期(OR=3.388,95%CI:1.395~8.229,P=0.007)。孕妇睡眠期间的EEG觉醒指数与孕周呈负相关(β=-0.162,P=0.033),呼吸觉醒指数(β=0.069,P=0.028)和氧减觉醒指数(β=0.013,P=0.041)分别与PPBMI呈正相关。结论妊娠早期和中期孕妇睡眠质量有一定程度的降低,孕中期睡眠潜伏期延长更严重。Objective To explore the characteristics of sleep quality of pregnant women in early and middle pregnancy.Methods A total of 177 pregnant women in the early and middle pregnancy who received prenatal examination and portable monitoring in Beijing Obstetrics and Gynecology Hospital from September 2020 to March 2022 were selected,and were divided into early pregnancy group(gestational week≤13^(+6)weeks,108 cases)and middle pregnancy group(14^(+0)weeks≤gestational week≤27^(+6)weeks,69 cases).Characteristics and differences of sleep quality related indicators were analyzed and compared between the two groups.Results The median age of 177 pregnant women was 33.8(31.1,36.7)years,and the median pre-pregnancy body mass index(PPBMI)was 28.1(25.8,30.1)kg/m^(2),the median gestational age was 12.0(10.0,16.0)weeks.Compared with the early pregnancy group,the middle pregnancy group had lower PPBMI,longer sleep latency(N2 latency,N3 latency),lower sleep efficiency,lower EEG awakening index during non-rapid eye movement(NREM),lower respiratory awakening index,and shorter maximum duration of hypopnea,with statistical significances(all P<0.05).41.2%of the pregnant women suffered from at least one sleep quality problem,including low sleep efficiency(21.5%,38/177),prolonged sleep latency(16.9%,30/177),fragmented sleep(10.2%,18/177)and shortened sleep duration(5.6%,10/177).The risk of prolonged sleep latency was significantly higher in middle pregnancy group than that of the early pregnancy group(OR=3.388,95%CI:1.395-8.229,P=0.007).EEG arousal index of pregnant women during sleep was negatively correlated with gestational age(β=-0.162,P=0.033),while the respiratory arousal index(β=0.069,P=0.028)and hypoxic arousal index(β=0.013,P=0.041)were positively correlated with PPBMI,respectively.Conclusions The sleep quality of pregnant women in the first and middle stages of pregnancy is reduced to some extent,and the prolonged sleep latency in the middle pregnancy is more serious.

关 键 词：睡眠呼吸监测 睡眠质量 睡眠效率 妊娠期 

分 类 号：R714[医药卫生—妇产科学]