Obstructive sleep apnea is associated with alterations in markers of fetoplacental wellbeing
Obstructive sleep apnea is associated with alterations in markers of fetoplacental wellbeing
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DOI：
10.3109/14767058.2014.913131
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发表时间：
2015-02-01
影响因子：
1.8
通讯作者：
Lambert-Messerlian, Geralyn
中科院分区：
文献类型：
--
作者：
Bourjeily, Ghada;Butterfield, Kristen;Lambert-Messerlian, Geralyn
背景：在一些研究中，阻塞性睡眠呼吸暂停（OSA）与不良胎儿结局有关。妊娠中期唐氏综合征筛查标志物反映胎儿和胎胎盘的健康状况。我们的目的是比较OSA患者和低风险对照组的胎儿和胎胎盘健康指标。方法：采用回顾性病例对照研究，对患有OSA的孕妇和现有的妊娠中期标志物进行研究。对照组在分娩时使用问卷筛查睡眠呼吸障碍（SDB）。选择患阻塞性睡眠呼吸暂停低风险的妇女。标志物水平根据胎龄和种族进行调整，并以中位数的倍数报告，随后根据体重指数（BMI）进行调整。结果：共发现24例OSA病例和166例对照。与对照组相比，OSA患者的平均BMI更高（37.1 +/- 12.7 vs 24.1 +/- 5.1, p = 0.03）。即使在调整BMI后，OSA女性的雌三醇（u3）中位数（MoM）水平也比对照组低，分别为0.74（四分位数间距（IQR） 0.45）和1.06 (IQR 0.38), p = 0.026。一旦调整BMI，与对照组相比，OSA女性的α胎蛋白（AFP） MoM水平不再有显著差异。结论：OSA与血清uE3水平降低相关，与BMI无关，可能提示胎儿窘迫。
Background: Obstructive sleep apnea (OSA) has been associated with adverse fetal outcomes in some studies. Second trimester Down syndrome screening markers reflect fetal and fetoplacental wellbeing. We aimed to compare markers of fetal and feto-placental wellbeing in women with OSA and low risk controls.Methods: A retrospective case-control study of pregnant women with OSA and available second trimester markers was performed. Controls were screened for sleep disordered breathing (SDB) at the time of delivery using a questionnaire. Women at low risk for OSA were selected. Marker levels were adjusted for gestational age and race and reported as multiples of median and later adjusted for body mass index (BMI).Results: Twenty-four OSA cases and 166 controls were identified. Women with OSA had a higher mean BMI when compared to controls (37.1 +/- 12.7 versus 24.1 +/- 5.1, p = 0.03). Estriol (uE3) multiples of the median (MoM) levels were lower in women with OSA compared to controls, even after adjusting for BMI, 0.74 (interquartile range (IQR) 0.45) versus 1.06 (IQR 0.38), respectively, p = 0.026. Once adjusted for BMI, alpha feto-protein (AFP) MoM levels were no longer significantly different in women with OSA compared to controls.Conclusion: OSA is associated with reduced serum uE3 levels, independently of BMI, possibly indicating fetal distress.