在高风险妊娠中验证阻塞性睡眠呼吸暂停问卷
Kristin N Sheehan1, Kang Rui Xiang1, Courtney L Rowland2
1Section of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
概括
阻塞性睡眠呼吸暂停 (OSA) 在高危妊娠中很常见. DoISnorePreg问卷有效地选OSA,识别可能需要进一步评估和干预的孕妇.
科学领域:
- 产科和妇科 产科和妇科
- 睡眠医学 睡眠医学
- 肺部病理学 肺部病理学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是一个未被认可的妊娠并发症风险因素.
- 现有的睡眠问卷在识别有OSA风险的孕妇时具有可变的准确性.
研究的目的:
- 评估DoISnorePreg问卷对高风险产科患者的准确性.
- 将DoISnorePreg的表现与柏林问卷进行比较.
- 评估爱普沃思睡眠度量对该群体OSA预测的影响.
主要方法:
- 从高风险产科诊所招募的患者 (不包括患有妊娠前或妊娠糖尿病的患者).
- 管理睡眠问卷和在怀孕28周进行家庭睡眠呼吸暂停测试.
- 在怀孕期间跟踪患者以评估母亲和新生儿的结果,使用C统计来评估预测值.
主要成果:
- 39%的参与者有呼吸暂停-呼吸暂停指数≥5,其中29%有中度至重度的OSA.
- 患有OSA的患者表现出更高的BMI,更老的年龄,增加的嗜睡,更严重的氧气脱,更长的产后停留时间,以及更高的NICU入院率.
- DoISnorePreg (AUC 0.74) 的表现优于柏林问卷 (AUC 0.58);爱普沃思睡眠度量表没有提高表现. 一个DoISnorePreg值≥4的积极反应产生89%的敏感性和43%的OSA风险的特异性.
结论:
- 在高风险的产科患者中,OSA的患病率很高,需要进行查.
- 氧气不和,延长住院时间,以及新生儿集中治疗室的入院,都强调了怀孕期间OSA的临床意义.
- DoISnorePreg是用于查高风险人群的验证工具,解决了关键的护理差距.
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