Maternal obstructive sleep apnea and neonatal birth outcomes in a population based sample.
Maternal obstructive sleep apnea and neonatal birth outcomes in a population based sample.
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DOI：
10.1016/j.sleep.2019.01.019
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发表时间：
2020-02
期刊：
影响因子：
4.8
通讯作者：
Lipkind H
中科院分区：
文献类型：
--
作者：
Bourjeily G;Danilack VA;Bublitz MH;Muri J;Rosene-Montella K;Lipkind H
评估阻塞性睡眠呼吸暂停综合征与分娩结局的关系，包括先天性畸形的风险以及分娩时需要更高水平的临床护理。以人口为基础的研究，将新生儿记录与产妇记录联系起来。来自美国所有地理普查部门的95个围产期中心的数据显示，从2010年到2014年，被诊断为分娩的妇女的记录可能与相应的新生儿记录有关。睡眠呼吸暂停的国际疾病分类第九版(ICD-9)代码被用来识别暴露和结果变量。采用包括药物使用、肥胖、糖尿病、母体合并症和妊娠并发症的模型进行单变量和多变量Logistic回归分析。在这项研究中，1,423,099份产妇记录被链接到活的新生儿记录。OSA与子代发生先天畸形的风险较高(AOR 1.26，1.11~1.43)，其中最高的风险是肌肉骨骼异常(AOR 1.89，1.16~3.07)，调整了合并症和潜在的致畸因素。患有阻塞性睡眠呼吸暂停综合征的母亲所生的新生儿更有可能住进重症监护室(25.3%比8.1%，p<；0.001)，需要复苏(比2.76，1.35比5.64)，住院时间更长(比比2.25，1.85比2.65)。虽然我们的研究没有建立因果关系，但它是第一次证明患有阻塞性睡眠呼吸暂停综合征的母亲的新生儿先天异常和出生时复苏的风险更高，强调了在孕妇和育龄妇女中识别阻塞性睡眠呼吸暂停综合征的重要性。
Evaluate the association of OSA with birth outcomes including the risk of congenital anomalies and the need for a higher level of clinical care at delivery. Population-based study that linked newborn records with maternal records. Data from 95 perinatal centers across all geographic census divisions of the U.S. of women with a delivery diagnosis from 2010 to 2014 whose records could be linked to the corresponding newborn record. An International Classification of Diseases, ninth Revision (ICD-9) code for sleep apnea was used to identify exposure and outcome variables. Univariate and multivariate logistic regression analyses were performed with a model that included substance use, obesity, diabetes, maternal co-morbidities, and pregnancy complications. In this study, 1,423,099 maternal records were linked to live newborn records. OSA was associated with a higher risk for congenital anomalies in offspring (aOR 1.26, 1.11 to 1.43), with the highest risk being that of musculoskeletal anomalies (aOR 1.89, 1.16 to 3.07) after adjusting for comorbidities and potential teratogens. Neonates born to mothers with OSA were more likely to be admitted to the intensive care unit (25.3% vs. 8.1%, p < 0.001), require resuscitation (aOR 2.76, 1.35 to 5.64) and have a longer hospital stay (aOR 2.25, 1.85 to 2.65). Although our study does not establish causation, it is the first to demonstrate a higher risk of congenital anomalies and resuscitation at birth in neonates of mothers with OSA, emphasizing the importance of identifying OSA in pregnant women and women of reproductive age.
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