体重指数和阻塞性睡眠呼吸暂停对孕前风险的联合影响
Nana A Mensah1,2, Michael J Fassett3,4, Morgan R Peltier5,6
1Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
American journal of perinatology
|April 7, 2025
概括
肥胖和阻塞性睡眠呼吸暂停 (OSA) 独立地增加了孕前的风险. 当这些情况一起发生时,它们具有附加效应,突出显示需要监测超重孕妇的可修改风险因素.
科学领域:
- 产科和妇科 产科和妇科
- 围产儿医学 围产儿医学
- 睡眠医学 睡眠医学
背景情况:
- 孕前是全球孕产妇和婴儿死亡的主要原因之一.
- 在怀孕早期确定可修改的风险因素对于减少妊娠前发病率和不良后果至关重要.
- 孕前体重指数 (BMI) 和阻塞性睡眠呼吸暂停 (OSA) 对孕前风险的综合影响需要进一步研究.
研究的目的:
- 调查预孕BMI和OSA对患有孕前的风险的潜在协同效应.
- 量化与单独怀孕中高BMI和OSA相关的独立和综合风险.
主要方法:
- 对超过34万个单独怀孕的回顾性队列研究.
- 使用临床诊断代码确定子宫前和OSA.
- 使用多变量逻辑回归分析妊娠前的BMI类别 (正常,超重,肥胖) 和OSA诊断.
主要成果:
- 超重和肥胖的BMI独立地与妊娠前风险增加有关 (aRR分别为1.6和2.5).
- 阻塞性睡眠呼吸暂停 (OSA) 独立地与妊娠前风险增加有关 (aRR 2.2).
- 超重或肥胖的BMI与OSA的结合显著增加了孕前风险 (aRR分别为4.6和3.8),表明了附加效应,而不是协同效应.
结论:
- 妊娠前BMI和OSA的升高是产前的独立风险因素.
- 肥胖和OSA的联合存在导致先兆子风险的增加.
- 超重BMI和OSA的孕妇应对这些可修改的风险因素进行密切监测和早期干预.
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