Pregnancy-Related Sleep Disturbances May Increase Pregnancy Complications

描述(由申请人提供)：这项研究计划的目标是研究与怀孕相关的睡眠障碍如何增加怀孕并发症的发生率。炎症在妊娠并发症发病机制中的作用越来越引起人们的兴趣，睡眠可能在炎症过程与妊娠并发症之间的关系中发挥重要作用。女性经常支持在怀孕期间睡眠中断，经常抱怨睡眠质量不佳，夜间觉醒增加，以及长时间清醒。越来越多的文献表明，在非妊娠人群中，睡眠障碍(质量差、连续性差或睡眠持续时间短)与循环和分泌的促炎细胞因子水平增加有关。在我的研究生生涯中进行的初步工作提供了初步证据，表明与怀孕有关的睡眠障碍与促炎细胞因子的类似变化有关。这些同样的促炎细胞因子被证明会随着睡眠中断而改变，与妊娠并发症类似，如自然流产、先兆子痫、妊娠期糖尿病以及早产和分娩。目的1.研究睡眠在妊娠并发症中的作用。假设1：睡眠障碍会增加妊娠并发症的发生率，包括自然流产、先兆子痫、妊娠期糖尿病、早产和分娩。目的2.研究妊娠期睡眠与促炎细胞因子的时间关系。假设2：睡眠障碍将与随后促炎细胞因子的增加相关。目的3.研究与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：与睡眠相关的促炎细胞因子的增加将与妊娠并发症的发生率增加有关，包括自然流产、先兆子痫、妊娠期糖尿病、早产和分娩。总共120名孕妇将在怀孕期间接受研究。每位妇女将每三个月参加一次为期15天的评估。这些评估将包括通过活动记录、睡眠日记和睡眠问卷获得的睡眠数据；通过血浆和刺激分析确定的细胞因子数据；通过自我报告评估的健康行为；以及医疗记录提供的关于怀孕并发症的数据。

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.