Sleep-disordered breathing and pregnancy: potential mechanisms and evidence for maternal and fetal morbidity
Sleep-disordered breathing and pregnancy: potential mechanisms and evidence for maternal and fetal morbidity
复制标题
DOI：
10.1097/mcp.0b013e32833f0d55
复制
发表时间：
2010-11-01
影响因子：
3.3
通讯作者：
Pien, Grace W.
中科院分区：
文献类型：
--
作者：
Izci-Balserak, Bilgay;Pien, Grace W.
综述的目的本文综述了妊娠期睡眠呼吸紊乱可能造成危害的病理生理机制的最新数据，并探索了相关的不良母婴结局的生物学途径，特别是妊娠高血压综合征和妊娠期糖尿病。最近的研究发现，越来越多的数据表明，妊娠期打鼾症和睡眠呼吸暂停可能增加妊娠期高血压和先兆子痫的风险。几项新的研究发现，睡眠呼吸紊乱和睡眠时间短也会增加妊娠期糖尿病的风险，这与在普通人群中的观察结果类似。关于潜在的机制，有不同程度的新证据，包括氧化应激，交感神经活性增加和炎症，脂肪因子水平和胰岛素抵抗，将怀孕期间睡眠障碍呼吸事件与不良后果联系起来。综述睡眠障碍呼吸和不良母婴结局，如先兆子痫和妊娠期糖尿病，共享一些机制途径，越来越多的孕妇数据表明，打鼾声和睡眠呼吸暂停增加了母亲和胎儿这些和其他并发症的风险。然而，关于妊娠期间睡眠障碍呼吸产生负面影响的病理生理机制的直接证据仍然很少。
Purpose of reviewThis article reviews current data on pathophysiologic mechanisms by which sleep-disordered breathing during pregnancy may cause harm, and explores biological pathways for associated adverse maternal and fetal outcomes, especially pregnancy-induced hypertension and gestational diabetes.Recent findingsAccumulating data indicate that snoring and sleep apnea during pregnancy are likely to increase the risk for gestational hypertension and preeclampsia. Several new studies have observed that sleep-disordered breathing and short sleep duration also increase the risk of gestational diabetes, similar to observations in the general population. There are varying levels of emerging evidence for potential mechanisms, including oxidative stress, increased sympathetic activity and inflammation, adipokine levels and insulin resistance, linking sleep-disordered breathing events during pregnancy to adverse outcomes.SummarySleep-disordered breathing and adverse maternal-fetal outcomes such as preeclampsia and gestational diabetes share a number of mechanistic pathways, and growing data in pregnant women indicate that snoring and sleep apnea increase the risk of these and other complications for both the mother and the fetus. Nevertheless, direct evidence of the pathophysiologic mechanisms by which sleep-disordered breathing during pregnancy exerts negative effects remains sparse.