Predictors of de novo development of obstructive sleep apnea in pregnancy

项目摘要 睡眠呼吸障碍在怀孕人群中更常见;然而， 迄今为止的研究已经评估了这种疾病的妊娠发作发展的具体预测因素。是 可能的是，随着妊娠生理学的暴露，具有特定表型的女性更有可能 会导致阻塞性睡眠呼吸暂停 该项目的目的是：1）评估女性的人体测量和身体成分变量， 妊娠早期无阻塞性睡眠呼吸暂停; 2）检查生理和生物学指标 纵向变化，并与妊娠期新发阻塞性睡眠呼吸暂停的发生有关; （3）评价睡眠前后头侧液体移位在阻塞性睡眠呼吸暂停发病机制中的作用。 该研究将招募肥胖孕妇。参加者将有身体测量 成分、相关人体测量指标、生物标志物-如女性激素、脂肪因子 和炎症标志物-肺功能测试和上气道通畅性测量，然后 室内睡眠呼吸暂停测试患有阻塞性睡眠呼吸暂停的妇女将与没有阻塞性睡眠呼吸暂停的妇女进行比较。 没有睡眠呼吸暂停的妇女将被纵向跟踪阻塞性睡眠的发展 通过重复家庭睡眠呼吸暂停测试怀孕期间的呼吸暂停。早孕措施和变化 妊娠期间的这些测量将被评估为新发阻塞性睡眠呼吸暂停的预测因子， 与呼吸暂停低通气指数和阻塞性睡眠呼吸暂停的其他多导睡眠图测量相关 在重复的家庭睡眠研究中获得。这一目标将有助于确定具体的怀孕 动态变化使一些有风险的妇女易患阻塞性睡眠呼吸暂停，而不是其他妇女， 怀孕为了进一步了解睡眠中液体转移的作用，将邀请一组女性参与研究。 进行实验室多导睡眠图测试，测量腿部和颈部周长， 除了评估液体从下肢转移之外，还获得了。 从这项研究中获得的知识将帮助我们确定将女性置于风险中的因素， 在怀孕期间发展新生阻塞性睡眠呼吸暂停为有针对性的筛查铺平了道路 战略布局这种研究还将有助于确定有可能发生这些并发症的妇女， 在干预性试验中进行。

Project Summary Sleep disordered breathing occurs more commonly in the pregnant population; however, there has been no research to date that has assessed specific predictors of pregnancy-onset development of this disorder. It is possible that, with the exposure to pregnancy physiology, women with a specific phenotype are more likely to develop obstructive sleep apnea. The aim of this project is to 1) assess anthropometric and body composition variables in women with and without obstructive sleep apnea in early pregnancy; 2) examine physiologic and biological measures longitudinally and relate changes to the development of new-onset obstructive sleep apnea in pregnancy; and 3) evaluate the role of rostral fluid shifts around sleep in the pathogenesis of obstructive sleep apnea. The study will enroll pregnant women with obesity. Participants will have measurements of body composition, relevant anthropometric measures, biological markers –such as female hormones, adipokines and inflammatory markers-, pulmonary function tests and upper airway patency measurements, followed by in-home sleep apnea testing. Women with obstructive sleep apnea will be compared to those without. Women without sleep apnea will then be followed longitudinally for the development of obstructive sleep apnea during pregnancy by repeat home sleep apnea testing. Early pregnancy measures and changes in these measures during gestation will be assessed as predictors of new onset obstructive sleep apnea and related to apnea hypopnea indices and other polysomnographic measures of obstructive sleep apnea obtained on repeat in-home sleep studies. This aim will facilitate the identification of specific pregnancy dynamic changes that predispose some women at risk, but not others, to develop obstructive sleep apnea in pregnancy. To further understand the role of fluid shifts during sleep, a subgroup of women will be invited to have an in-laboratory polysomnography test where measurement of leg and neck circumference will be obtained in addition to an assessment of fluid shifts from the lower extremities. The knowledge gained from this study will help us identify factors that would place a woman at risk for developing de novo obstructive sleep apnea during pregnancy paving the way for targeted screening strategies. Such research will also facilitate the identification of women at risk for these complications to be pursued in interventional trials.