妊娠期阻塞性睡眠呼吸暂停筛查的研究进展

doi:10.12114/j.issn.1007-9572.2022.0754

中国全科医学 ›› 2023, Vol. 26 ›› Issue (20): 2555-2558.DOI: 10.12114/j.issn.1007-9572.2022.0754

所属专题：睡眠问题专题研究

妊娠期阻塞性睡眠呼吸暂停筛查的研究进展

王晶玉¹, 洪申达², 韩芳¹, 刘国莉³^,^*()

1．100044　北京市，北京大学人民医院呼吸睡眠医学科
2．100191　北京市，北京大学健康医疗大数据国家研究院
3．100044　北京市，北京大学人民医院妇产科

收稿日期:2022-08-22 修回日期:2022-11-25 出版日期:2023-07-15 发布日期:2022-12-29
通讯作者: 刘国莉
作者贡献：王晶玉进行文献收集整理、撰写论文；洪申达、韩芳、刘国莉进行论文的修订；韩芳、刘国莉负责文章的质量控制及审校，对文章整体负责，监督管理。
基金资助:
北京大学人民医院研究与发展基金(PTU2021-01)

A Review of Recent Advances in Screening for Obstructive Sleep Apnea during Pregnancy

WANG Jingyu¹, HONG Shenda², HAN Fang¹, LIU Guoli³^,^*()

1. Department of Respiratory and Sleep Medicine, Peking University People's Hospital, Beijing 100044, China
2. National Institute of Health Data Science at Peking University, Beijing 100191, China
3. Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China

Received:2022-08-22 Revised:2022-11-25 Published:2023-07-15 Online:2022-12-29
Contact: LIU Guoli

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摘要/Abstract

摘要： 阻塞性睡眠呼吸暂停（OSA）是妊娠人群中常见的睡眠呼吸障碍性疾病，不仅与多种不良妊娠结局相关，也可能对母婴远期健康产生重要影响。目前诊断OSA的金标准多导睡眠监测在妊娠人群中难以大规模开展，导致绝大多数妊娠期OSA未能得到及时诊断。寻求其他筛查策略和筛查工具准确识别具有OSA风险的孕妇并进行及时诊治，对于改善不良妊娠结局具有重要意义。本文针对妊娠期OSA患病率、筛查现状、筛查时机、目标人群、筛查工具的研究进展进行综述，以期为妊娠期OSA的筛查提供参考和理论依据。

关键词: 睡眠呼吸暂停, 阻塞性, 妊娠, 筛查, 家庭睡眠呼吸暂停监测, 多道睡眠描记术, 综述

Abstract:

Obstructive sleep apnea (OSA) is a common sleep-disordered breathing in pregnant population, which is associated with adverse perinatal outcomes, and may have long-term health consequences on both mothers and children. Currently, the vast majority of pregnant women are underdiagnosed due to the difficulties in extensively performing polysomnography, a gold standard in OSA diagnosis. So it is essential to seek other screening strategies and tools to accurately identify pregnant women with high risk of OSA to improve their perinatal outcomes. We reviewed the prevalence of OSA in pregnancy, screening status, screening timing, target population and recent advances in screening tools, to providing a theoretical basis for implementing the screening in this group.

Key words: Sleep apnea, obstructive, Pregnancy, Screening, Home sleep apnea test, Polysomnography, Review

王晶玉,洪申达,韩芳,等. 妊娠期阻塞性睡眠呼吸暂停筛查的研究进展[J]. 中国全科医学, 2023, 26(20): 2555-2558. DOI: 10.12114/j.issn.1007-9572.2022.0754.
WANG Jingyu,HONG Shenda,HAN Fang, et al. A Review of Recent Advances in Screening for Obstructive Sleep Apnea during Pregnancy[J]. Chinese General Practice, 2023, 26(20): 2555-2558. DOI: 10.12114/j.issn.1007-9572.2022.0754.

参考文献 39

[1]	LIU L N, SU G, WANG S L，et al. The prevalence of obstructive sleep apnea and its association with pregnancy-related health outcomes：a systematic review and meta-analysis[J]. Schlaf Atmung，2019，23(2):399-412. DOI：10.1007/s11325-018-1714-7.
[2]	PANYARATH P, GOLDSCHER N, PAMIDI S，et al. Effect of maternal obstructive sleep apnea-hypopnea on 24-hour blood pressure，nocturnal blood pressure dipping and arterial stiffness in hypertensive disorders of pregnancy[J]. Front Physiol，2021，12:747106. DOI：10.3389/fphys.2021.747106.
[3]	PHAN K, PAMIDI S, GOMEZ Y H，et al. Sleep-disordered breathing in high-risk pregnancies is associated with elevated arterial stiffness and increased risk for preeclampsia[J]. Am J Obstet Gynecol，2022，226(6):833.e1-833.e20. DOI：10.1016/j.ajog.2021.11.1366.
[4]	FACCO F L, PARKER C B, REDDY U M，et al. Association between sleep-disordered breathing and hypertensive disorders of pregnancy and gestational diabetes mellitus[J]. Obstet Gynecol，2017，129(1):31-41. DOI：10.1097/AOG.0000000000001805.
[5]	LU Q D, ZHANG X Y, WANG Y H，et al. Sleep disturbances during pregnancy and adverse maternal and fetal outcomes：a systematic review and meta-analysis[J]. Sleep Med Rev，2021，58:101436. DOI：10.1016/j.smrv.2021.101436.
[6]	BELLAMY L, CASAS J P, HINGORANI A D，et al. Type 2 diabetes mellitus after gestational diabetes：a systematic review and meta-analysis[J]. Lancet，2009，373(9677):1773-1779. DOI：10.1016/S0140-6736(09)60731-5.
[7]	TAPIA I E, SHULTS J, DOYLE L W，et al. Perinatal risk factors associated with the obstructive sleep apnea syndrome in school-aged children born preterm[J]. Sleep，2016，39(4):737-742. DOI：10.5665/sleep.5618.
[8]	MORRAKOTKHIEW W, CHIRDKIATGUMCHAI V, TANTRAKUL V，et al. Early developmental outcome in children born to mothers with obstructive sleep apnea[J]. Sleep Med，2021，88:90-95. DOI：10.1016/j.sleep.2021.10.010.
[9]	MALHAMÉ I, BUBLITZ M H, BOURJEILY G. The challenge of screening for obstructive sleep apnea in pregnancy[J]. Ann Am Thorac Soc，2019，16(10):1242-1244. DOI：10.1513/AnnalsATS.201907-507ED.
[10]	TANTRAKUL V, SIRIJANCHUNE P, PANBURANA P，et al. Screening of obstructive sleep apnea during pregnancy：differences in predictive values of questionnaires across trimesters[J]. J Clin Sleep Med，2015，11(2):157-163. DOI：10.5664/jcsm.4464.
[11]	LOCKHART E M, BEN ABDALLAH A, TUULI M G，et al. Obstructive sleep apnea in pregnancy：assessment of current screening tools[J]. Obstet Gynecol，2015，126(1):93-102. DOI：10.1097/AOG.0000000000000848.
[12]	FACCO F L, OUYANG D W, ZEE P C，et al. Development of a pregnancy-specific screening tool for sleep apnea[J]. J Clin Sleep Med，2012，8(4):389-394. DOI：10.5664/jcsm.2030.
[13]	OLIVAREZ S A, MAHESHWARI B, MCCARTHY M，et al. Prospective trial on obstructive sleep apnea in pregnancy and fetal heart rate monitoring[J]. Am J Obstet Gynecol，2010，202(6):552.e1-552.e7. DOI：10.1016/j.ajog.2009.12.008.
[14]	WILSON D L, WALKER S P, FUNG A M，et al. Can we predict sleep-disordered breathing in pregnancy? The clinical utility of symptoms[J]. J Sleep Res，2013，22(6):670-678. DOI：10.1111/jsr.12063.
[15]	TANTRAKUL V, NUMTHAVAJ P, GUILLEMINAULT C，et al. Performance of screening questionnaires for obstructive sleep apnea during pregnancy：a systematic review and meta-analysis[J]. Sleep Med Rev，2017，36:96-106. DOI：10.1016/j.smrv.2016.11.003.
[16]	HAN F. Development of sleep medicine in China[J]. Chin Med J（Engl），2009，122(12):1462-1463.
[17]	DOMINGUEZ J E, KRYSTAL A D, HABIB A S. Obstructive sleep apnea in pregnant women：a review of pregnancy outcomes and an approach to management[J]. Anesth Analg，2018，127(5):1167-1177. DOI：10.1213/ANE.0000000000003335.
[18]	SANAPO L, GOLDMAN D, BOURJEILY G. Obstructive sleep apnea in pregnancy：1 sleep study may not be enough in high-risk women[J]. J Clin Sleep Med，2021，17(9):1953-1956. DOI：10.5664/jcsm.9340.
[19]	许琦，刘国莉，王山米. 重视妊娠期阻塞性睡眠呼吸暂停的临床诊治[J]. 实用妇产科杂志，2019，35(2):106-109.
[20]	CHUNG F, MEMTSOUDIS S G, RAMACHANDRAN S K，et al. Society of anesthesia and sleep medicine guidelines on preoperative screening and assessment of adult patients with obstructive sleep apnea[J]. Anesth Analg，2016，123(2):452-473. DOI：10.1213/ANE.0000000000001416.
[21]	妊娠期阻塞性睡眠呼吸暂停低通气综合征临床诊治专家共识写作组. 妊娠期阻塞性睡眠呼吸暂停低通气综合征临床诊治专家共识（草案）[J]. 中国呼吸与危重监护杂志，2018，17(5):439-444. DOI：10.7507/1671-6205.201809006.
[22]	CHIU H Y, CHEN P Y, CHUANG L P，et al. Diagnostic accuracy of the Berlin questionnaire，STOP-BANG，STOP，and Epworth sleepiness scale in detecting obstructive sleep apnea：a bivariate meta-analysis[J]. Sleep Med Rev，2017，36:57-70. DOI：10.1016/j.smrv.2016.10.004.
[23]	DAMIANI M F, QUARANTA V N, FALCONE V A，et al. The Epworth Sleepiness Scale：conventional self vs physician administration[J]. Chest，2013，143(6):1569-1575. DOI：10.1378/chest.12-2174.
[24]	KANG K, PARK K S, KIM J E，et al. Usefulness of the Berlin Questionnaire to identify patients at high risk for obstructive sleep apnea：a population-based door-to-door study[J]. Schlaf Atmung，2013，17(2):803-810. DOI：10.1007/s11325-012-0767-2.
[25]	CHUNG F, ABDULLAH H R, LIAO P. STOP-Bang questionnaire：a practical approach to screen for obstructive sleep apnea[J]. Chest，2016，149(3):631-638. DOI：10.1378/chest.15-0903.
[26]	SEDOV I D, CAMERON E E, MADIGAN S，et al. Sleep quality during pregnancy：a meta-analysis[J]. Sleep Med Rev，2018，38:168-176. DOI：10.1016/j.smrv.2017.06.005.
[27]	PENGO M F, WON C H, BOURJEILY G. Sleep in women across the life span[J]. Chest，2018，154(1):196-206. DOI：10.1016/j.chest.2018.04.005.
[28]	PIEN G W, FIFE D, PACK A I，et al. Changes in symptoms of sleep-disordered breathing during pregnancy[J]. Sleep，2005，28(10):1299-1305. DOI：10.1093/sleep/28.10.1299.
[29]	ANTONY K M, AGRAWAL A, ARNDT M E，et al. Association of adverse perinatal outcomes with screening measures of obstructive sleep apnea[J]. J Perinatol，2014，34(6):441-448. DOI：10.1038/jp.2014.25.
[30]	DOMINGUEZ J E, GROTEGUT C A, COOTER M，et al. Screening extremely obese pregnant women for obstructive sleep apnea[J]. Am J Obstet Gynecol，2018，219(6):613.e1-613.e10. DOI：10.1016/j.ajog.2018.09.001.
[31]	PEARSON F, BATTERHAM A M, COPE S. The STOP-Bang questionnaire as a screening tool for obstructive sleep apnea in pregnancy[J]. J Clin Sleep Med，2019，15(5):705-710. DOI：10.5664/jcsm.7754.
[32]	BOURJEILY G, CHAMBERS A, SALAMEH M，et al. Anthropometric measures and prediction of maternal sleep-disordered breathing[J]. J Clin Sleep Med，2019，15(6):849-856. DOI：10.5664/jcsm.7834.
[33]	IZCI-BALSERAK B, ZHU B Q, GURUBHAGAVATULA I，et al. A screening algorithm for obstructive sleep apnea in pregnancy[J]. Ann Am Thorac Soc，2019，16(10):1286-1294. DOI：10.1513/AnnalsATS.201902-131OC.
[34]	XU L Y, HAN F, KEENAN B T，et al. Validation of the nox-T3 portable monitor for diagnosis of obstructive sleep apnea in Chinese adults[J]. J Clin Sleep Med，2017，13(5):675-683. DOI：10.5664/jcsm.6582.
[35]	KAPUR V K, AUCKLEY D H, CHOWDHURI S，et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea：an American academy of sleep medicine clinical practice guideline[J]. J Clin Sleep Med，2017，13(3):479-504. DOI：10.5664/jcsm.6506.
[36]	O'BRIEN L M, BULLOUGH A S, SHELGIKAR A V，et al. Validation of watch-PAT-200 against polysomnography during pregnancy[J]. J Clin Sleep Med，2012，8(3):287-294. DOI：10.5664/jcsm.1916.
[37]	SHARKEY K M, WATERS K, MILLMAN R P，et al. Validation of the Apnea Risk Evaluation System（ARES） device against laboratory polysomnography in pregnant women at risk for obstructive sleep apnea syndrome[J]. J Clin Sleep Med，2014，10(5):497-502. DOI：10.5664/jcsm.3694.
[38]	FACCO F L, LOPATA V, WOLSK J M，et al. Can we use home sleep testing for the evaluation of sleep apnea in obese pregnant women?[J]. Sleep Disord，2019，2019:3827579. DOI：10.1155/2019/3827579.
[39]	FACCO F L, OUYANG D W, ZEE P C，et al. Sleep disordered breathing in a high-risk cohort prevalence and severity across pregnancy[J]. Am J Perinatol，2014，31(10):899-904. DOI：10.1055/s-0033-1363768.

妊娠期阻塞性睡眠呼吸暂停筛查的研究进展

A Review of Recent Advances in Screening for Obstructive Sleep Apnea during Pregnancy

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