2012-08-012024-05-14https://scholars.lib.ntu.edu.tw/handle/123456789/657377摘要：睡眠障礙是懷孕及產後婦女常見的健康問題，雖然已有研究觀察婦女從產前到產後睡眠的質與量的變化，且有研究報導孕期睡眠障礙增加妊娠高血壓、妊娠糖尿病、及胎兒生長遲滯之風險，孕期及產後婦女睡眠節律及自主神經功能之相關性則尚未被探討。目前另有間接證據指出婦女懷孕期間之身心健康影響胎兒的生長及發育，並以此推論對於嬰幼兒之長期健康應有絕對的影響，但目前文獻上尚無客觀長期性研究探討是否造成嬰兒睡眠問題的成因源自於母親懷孕時之睡眠障礙。因此，本三年期縱貫性研究之目的為: 1) 描述懷孕及產後婦女不同睡眠障礙的盛行率及嚴重程度; 2) 探討孕婦、產後婦女及嬰兒不同睡眠節律型態與自主神經調控心率變異之相關性; 3) 建立懷孕及產後婦女睡眠節律及自主神經功能對嬰兒睡眠節律發展影響之模式並加以驗證。本研究對象為240位健康於第三孕期之初產婦，第一階段為觀察母親懷孕期間之睡眠障礙、節律型態及心率變異，第二階段為母親產後三個月內觀察其與嬰兒之睡眠節律型態及心率變異。睡眠節律將利用活動紀錄器監測，心率變異將利用微型可移動式心電圖紀錄，母親主觀所經歷之睡眠障礙將以睡眠相關問卷評估。本研究成果將成為未來母嬰睡眠早期介入計畫相關研究之基礎。<br> Abstract: Sleep disturbance is a leading concern and a significant health issue in women duringpregnancy. It has been reported affecting more than 75 % of pregnant women and associatedwith several negative pregnancy outcomes. Although there is literature examining sleep inwomen from pregnancy to postpartum, maternal circadian sleep rhythm and autonomicnervous system (ANS) function have rarely been examined simultaneously. Mothersconstitute the primary physical and social environment for the young. Substantial evidencehas suggested that maternal health influences fetal growth and development and may haveimplications for the long-term health of the child. However, limited studies have addressedinfant sleep and rhythm development in the context of maternal rhythm and well-being. Giventhe known negative impact of sleep disturbance on maternal and fetal health, identifyingwhether sleep disturbance and circadian disruption during pregnancy and in the postpartumperiod may alter the regulation of maternal and infant ANS function is imperative to reduceassociated adverse pregnancy, birth, and infant health outcomes.The purpose of this 3-year longitudinal study is to exam sleep and circadian rhythm inwomen from pregnancy to postpartum and to identify the potential impact of maternal sleepand circadian disruption on maternal and infant ANS function as well as infant developingsleep and circadian rhythm. The specific aims include: 1) describe the prevalence and severityof the different sleep disturbances including short sleep duration, sleep disruption, daytimesleepiness, and snoring in women during the third trimester of pregnancy and within the firstthree months postpartum; 2) exam the relation between patterns of maternal sleep andcircadian rhythm and autonomic regulation of heart rate variability (HRV) during the thirdtrimester of pregnancy and within the first three months postpartum; 3) exam the relationbetween patterns of infant sleep and circadian rhythm and autonomic regulation of HRVduring the first three months of age; and 4) test a model of prenatal and postpartum maternalsleep, circadian rhythm, and ANS function for infant developing sleep and circadian rhythm.The proposed study will include 240 mother-infant dyads. Recruitment will targetwomen who are within the last trimester of pregnancy expecting their first child. Mothers andinfants recruited for this study will be studied in the home environment using an intensivewithin subject design. Women will be studied during the third trimester of their pregnancy andin the first three months postpartum. The infant age span for data collection will be withinthree months of age which captures the period of rapid development of sleep and circadianrhythm. Maternal and infant activity and sleep will be recorded continuously over a seven dayperiod using actigraphy. Maternal and infant HRV will be recorded using an ambulatoryelectrocardiogram. Analytic approaches to achieve the study aims include descriptivestatistics, cosinor analysis, partial correlation, and multiple regression with repeated measures.Understanding the relations among sleep, circadian rhythm, and autonomic function inmother-infant dyads will provide the basis for developing sleep enhancement strategies forwomen and their young infants.睡眠晝夜節律心率變異女性嬰兒sleepcircadian rhythmheart rate variabilitywomeninfants