Pregnancy-Related Sleep Disturbances May Increase Pregnancy Complications

描述（由申请人提供）：本研究计划的目的是研究与妊娠相关的睡眠障碍如何增加妊娠并发症的发生率。人们对炎症在妊娠并发症发病机制中的作用越来越感兴趣，睡眠可能在炎症过程和妊娠并发症之间的关系中发挥重要作用。女性在怀孕期间经常抱怨睡眠质量差、夜间醒来次数增加和长时间清醒，从而导致睡眠中断。越来越多的文献表明，在未怀孕人群中，睡眠紊乱（质量差、连续性差或睡眠时间短）与促炎细胞因子的循环和分泌水平增加之间存在关联。在我的研究生生涯中进行的初步工作提供了初步证据，表明与妊娠相关的睡眠障碍与促炎细胞因子的类似改变有关。这些促炎细胞因子被证明会随着睡眠中断而改变，与自然流产、先兆子痫、妊娠糖尿病、早产和分娩等妊娠并发症也有相似的关系。目的1。检查睡眠在妊娠并发症中的作用。假设1：睡眠紊乱会增加妊娠并发症的发生率，包括自然流产、先兆子痫、妊娠糖尿病、早产和分娩。目标2。检查怀孕期间睡眠和促炎细胞因子之间的时间关系。假设2：睡眠紊乱与随后的促炎细胞因子增加有关。目标3。检查睡眠相关的促炎细胞因子增加在妊娠并发症中的作用。假设3：睡眠相关的促炎细胞因子的增加与妊娠并发症的发生率增加有关，包括自然流产、先兆子痫、妊娠糖尿病、早产和分娩。共有120名孕妇将在怀孕期间接受研究。每位女性将在每个孕期参加一次为期15天的评估。这些评估将包括通过活动记录仪、睡眠日记和睡眠问卷获得的睡眠数据；从血浆和刺激试验中确定细胞因子数据；自我报告健康行为评估；以及医疗记录提供的妊娠并发症数据。

DESCRIPTION (provided by applicant): The goal of this research plan is to examine how pregnancy-related sleep disturbances may increase the incidence of pregnancy complications. There is a growing interest in the role of inflammation in the pathogenesis of pregnancy complications, and it is possible that sleep may play an important role in the relationship between inflammatory processes and pregnancy complications. Women often endorse disruption of sleep during pregnancy with frequent complaints of poor sleep quality, increased nocturnal awakenings and long periods of wakefulness. There is a mounting literature demonstrating an association between disturbed sleep (poor quality, poor continuity or short sleep duration) and increases in circulating and secreted levels of proinflammatory cytokines in nonpregnant populations. Preliminary work conducted during my graduate career provides initial evidence that pregnancy-related sleep disturbances are associated with similar alterations in proinflammatory cytokines. These same proinflammatory cytokines, shown to be altered with sleep disruption, are similarly associated with pregnancy complications such as spontaneous abortion, preeclampsia, gestational diabetes, and preterm labor and birth. Aim 1. Examine the role of sleep in pregnancy complications. Hypothesis 1: Disturbed sleep will be associated with increased incidence of pregnancy complications including spontaneous abortion, preeclampsia, gestational diabetes, and preterm labor and birth. Aim 2. Examine the temporal relationship between sleep and proinflammatory cytokines during pregnancy. Hypothesis 2: Disturbed sleep will be associated with subsequent increases in proinflammatory cytokines.Aim 3. Examine the role of sleep related increases in proinflammatory cytokines in pregnancy complications. Hypothesis 3: Sleep related increases in proinflammatory cytokines will be associated with increased incidence of pregnancy complications including spontaneous abortion, preeclampsia, gestational diabetes, and preterm labor and birth. A total of 120 pregnant women will be studied across pregnancy. Each woman will participate in a 15-day assessment once per trimester. These assessments will include sleep data attained by actigraphy, sleep diary and sleep questionnaires; cytokine data ascertained from plasma and stimulation assays; health behaviors assessed by self-report; and data on pregnancy complications provided by medical records.