The relationship and potential mechanistic pathways between sleep disturbances and maternal hyperglycemia.
The relationship and potential mechanistic pathways between sleep disturbances and maternal hyperglycemia.
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DOI：
10.1007/s11892-013-0459-8
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发表时间：
2014-02
影响因子：
4.2
通讯作者：
Pien GW
中科院分区：
文献类型：
--
作者：
Izci-Balserak B;Pien GW
本文综述了睡眠障碍对产妇高血糖，特别是妊娠期糖尿病（GDM）影响的最新研究进展。在世界范围内，高血糖的发病率和患病率都在增加，这是值得关注的，因为GDM甚至轻度高血糖都与不良妊娠结局有关。更好地了解产妇高血糖的睡眠相关危险因素是一个重要的健康问题。有证据表明睡眠障碍（尤其是睡眠呼吸障碍）与高血糖之间存在关联，但这些疾病之间的因果关系和潜在机制尚未完全阐明。主观睡眠评估显示睡眠障碍和母亲高血糖之间存在关联。然而，很少有研究使用客观测量来支持这些发现。需要大规模的前瞻性研究来检验睡眠障碍和产妇高血糖之间的因果关系。还需要进行更小的机制研究来了解病理生理学。此外，改善睡眠参数是否可以预防/降低产妇发生高血糖的风险，还需要进行干预性研究。综上所述，这些数据表明，怀孕期间的睡眠障碍对于识别和管理非常重要，以尽量减少产妇的高血糖和GDM，并改善产妇和胎儿的健康。
This paper reviews recent work investigating the influence of sleep disturbances on maternal hyperglycemia, particularly gestational diabetes mellitus (GDM). The incidence and prevalence of hyperglycemia are increasing worldwide, which is cause for concern because GDM and even mild hyperglycemia are associated with adverse pregnancy outcomes. A better understanding of sleep-related risk factors for maternal hyperglycemia is an important health matter. Evidence demonstrates associations between sleep disturbances, especially sleep-disordered breathing, and hyperglycemia, but causal effects and the underlying mechanisms linking these conditions have not been fully elucidated. Subjective sleep assessments show associations between sleep disturbances and maternal hyperglycemia. There are, however, few studies using objective measures to support these findings. Large prospective studies are required to examine causal relationships between sleep disturbances and maternal hyperglycemia. There is also a need for smaller mechanistic studies to understand the pathophysiology. Furthermore, interventional studies are required to address whether improvement of sleep parameters can prevent/decrease the risk of developing maternal hyperglycemia. Taken together, the data suggests that sleep disturbances during pregnancy are important to identify and manage in order to minimize maternal hyperglycemia and GDM, and improve maternal and fetal well-being.