Sleep quality and gestational diabetes in pregnant women: asystematic review and meta-analysis
Sleep quality and gestational diabetes in pregnant women: asystematic review and meta-analysis
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孕妇的睡眠质量和妊娠糖尿病：系统评价和荟萃分析
DOI：
10.1016/j.sleep.2019.11.1246
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发表时间：
2020
期刊：
影响因子：
4.8
通讯作者：
Sirimon Reutrakul
中科院分区：
文献类型：
--
作者：
Bingqian Zhu;Changgui Shi;Chang G. Park;Sirimon Reutrakul
睡眠质量差在孕妇中很常见。妊娠期糖尿病（GDM）与各种不良的孕产妇和新生儿结局有关。本系统综述的目的是研究睡眠质量差与妊娠期糖尿病风险之间的关系。根据系统性综述和荟萃分析的首选报告项目指南，从开始到2019年2月，在5个电子数据库中进行了系统检索。对研究孕妇睡眠质量和血糖之间关系的研究进行了筛选。使用固定效应模型，根据汇总数据计算合并比值比（OR）和95%置信区间（CI）。13项非实验性研究（n = 21，194名女性）符合纳入条件。在9项研究中，使用主观问卷和4项研究中的客观方法（活动记录仪或多导睡眠图）测量睡眠质量差。GDM通常按照标准指南进行诊断。8项研究被纳入GDM的荟萃分析。总的来说，自我报告的睡眠质量差是GDM的一个重要危险因素（合并OR = 1.43，95%CI：1.16，1.77，p = 0.001）。三项研究检查了客观睡眠质量和GDM之间的关系，但没有观察到显着的关系。主观睡眠质量差与GDM风险增加有关，而客观测量的睡眠质量则无关。该综述受到睡眠质量评估的限制。未来更大规模的研究是必要的，以检查睡眠质量对妊娠期葡萄糖代谢的影响。理想情况下，这些研究应该使用经过验证的问卷和客观方法来测量睡眠质量。这些将为改善妊娠期睡眠和探索其对葡萄糖代谢的影响提供进一步的指导。
Poor sleep quality is very common among pregnant women. Gestational diabetes mellitus (GDM) has been related to various adverse maternal and neonatal outcomes. The aim of this systematic review was to examine the association between poor sleep quality and gestational diabetes risk. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted in five electronic databases from inception to February 2019. Studies that examined the relationship between sleep quality and glucose in pregnant women were screened for eligibility. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated from aggregate data using a fixed-effect model. Thirteen non-experimental studies (n = 21,194 women) were eligible for inclusion. Poor sleep quality was measured using subjective questionnaires in nine studies and objective methods (actigraphy or polysomnography) in four studies. GDM was typically diagnosed following standard guidelines. Eight studies were included in the meta-analysis for GDM. Overall, self-reported poor sleep quality was a significant risk factor for GDM (pooled OR = 1.43, 95%CI: 1.16,1.77, p = 0.001). Three studies examined the association between objective sleep quality and GDM, but no significant relationship was observed. Subjective poor sleep quality was related to an increased risk for GDM, while objectively measured sleep quality was not. This review was limited by the assessment of sleep quality. Future larger studies are warranted to examine the effects of sleep quality on glucose metabolism in pregnancy. Ideally, these studies should measure sleep quality using both validated questionnaires and objective methods. These will provide further directions for improving sleep during pregnancy and exploring its effects on glucose metabolism.