Patient and provider perceptions of sleep disordered breathing assessment during prenatal care: a survey-based observational study
Patient and provider perceptions of sleep disordered breathing assessment during prenatal care: a survey-based observational study
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DOI：
10.1177/1753465812444958
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发表时间：
2012-08-01
影响因子：
4.3
通讯作者：
O'Connor, Kathleen
中科院分区：
文献类型：
--
作者：
Bourjeily, Ghada;Raker, Christina;O'Connor, Kathleen
目的：筛查睡眠呼吸障碍（SDB）在一般人群中仍然很差，尽管有证据表明与不良结局相关，并且治疗可改善某些结局。过去十年的数据表明打鼾与不良妊娠结局（包括妊娠期高血压疾病）之间存在关联。然而，目前尚不清楚怀孕期间筛查SDB的频率。本研究的目的是评估是否，以及如何，SDB的症状进行评估，在产前护理。方法：本研究被设计为一项调查为基础的观察性研究。在分娩后48小时内，对讲英语的患者进行了关于产前与产科医生就SDB症状进行对话的调查。在类似的时间段内，产科医生完成了一份匿名问卷，关于他们如何经常讨论相同的症状在产前visits.Results：共有776例患者和80个供应商执行大多数分娩在同一家医院回答了调查。护士比医生更经常询问睡眠质量;然而，两组对打鼾问题的回答相似。住院医师最不可能询问睡眠质量。不到3%的供应商报告询问打鼾，与患者的反应密切相关。共有44%的受访患者超重，21.7%肥胖。虽然32%的患者打鼾，但只有5%的人在产前检查时被问及打鼾问题。肥胖妇女和妇女的妊娠期高血压疾病的历史更有可能被问及snore.Conclusions：根据患者和产科提供者的回忆的讨论，SDB的问题是评估不佳，在常规产前护理，尽管超重和肥胖的患病率不断增加的孕妇人群。
Objectives: Screening for sleep disordered breathing (SDB) remains poor in the general population, despite evidence for association with adverse outcomes and improvement of certain outcomes with therapy. Data from the past decade have suggested an association between snoring and adverse pregnancy outcomes including gestational hypertensive disorders. However, it is unclear how often SDB is screened for in pregnancy. The objective of this study was to evaluate whether, and how, symptoms of SDB are assessed during prenatal care.Methods: This study was designed as a survey-based observational study. Within 48 hours of delivery, English-speaking patients were surveyed regarding prenatal conversations with obstetric providers about symptoms of SDB. During a similar time period, obstetric providers completed an anonymous questionnaire regarding how often they discussed the same symptoms during prenatal visits.Results: A total of 776 patients and 80 providers performing the majority of deliveries at the same hospital answered the survey. Nurse providers asked about sleep quality significantly more often than physician providers; however, responses to questions about snoring were similar in both groups. Resident physicians were the least likely to ask about sleep quality. Less than 3% of providers reported asking about snoring, closely matching patient responses. A total of 44% of patients surveyed were overweight and 21.7% were obese. Although 32% of patients snored, only 5% were asked about snoring during a prenatal visit. Obese women and women with a history of gestational hypertensive disorders were more likely to report being asked about snoring.Conclusions: Based on patient and obstetric provider recollections of discussions, the issue of SDB is poorly assessed during routine prenatal care, despite an increasing prevalence of overweight and obesity in the pregnant population.