2012-08-012024-05-14https://scholars.lib.ntu.edu.tw/handle/123456789/656675摘要：睡眠呼吸障礙是睡眠時發生異常呼吸型態進而影響氣體交換之疾病，懷孕婦女由於孕期體重增加及上呼吸道易水腫，造成婦女於懷孕期間睡眠呼吸障礙發生率明顯增加20%，罹患睡眠呼吸障礙之孕婦由於睡眠時須不斷醒起換氣，故易造成嚴重睡眠中斷和白天嗜睡，且睡眠時之血氧飽和濃度下降更可能造成胎盤缺氧。國外已有孕期睡眠呼吸障礙之相關報導，然而臺灣孕婦於產前門診並未常規評估睡眠呼吸障礙及其相關症狀，故臺灣各孕期睡眠呼吸障礙症狀之發生率及其對懷孕結果之影響皆尚未被探討。本三年期前驅性縱貫性研究預招募245位孕婦，從第一孕期至第三孕期各孕期追蹤一次睡眠及臨床生理檢查數值，第一年之研究預招募80位孕婦進行多頻道睡眠生理檢查，測試睡眠呼吸障礙症狀自評量表中文版之效度，並建立適當臨界值以正確篩檢孕期睡眠呼吸障礙。第二年及第三年之研究預招募165位孕婦，利用第一年已建立效度之中文版量表，評估各孕期睡眠呼吸障礙及其症狀之發生率、嚴重程度及危險因子。三年研究所有孕婦之資料將用來檢驗中文版量表完整之信效度，並分析睡眠呼吸障礙及其症狀嚴重程度對懷孕結果之影響，本研究成果將成為未來孕期睡眠障礙是否需納入臨床常規產前評估之重要依據。<br> Abstract: Sleep disordered breathing (SDB) is a group of disorders characterized by abnormalrespiratory patterns and abnormal gas exchange during sleep. SDB increases duringpregnancy by 20% and leads to significant sleep disruption, daytime sleepiness, fatigue,oxygen desaturation, and a decrease in placenta oxygenation. Several American and Europeanstudies have described the incidence and adverse pregnancy outcomes such as gestationaldiabetes and hypertension of SDB in pregnant women and reported body mass index playingan important role in development of SDB symptoms. However, our preliminary data indicatethat the average pre-pregnancy and pregnancy body mass index of the women in Taiwan aremuch lower than those reported in the American and European studies but with similar ratesof women with high symptoms of SDB. Pregnant women in Taiwan are not routinely assessedfor symptoms of SDB. The risk factors for SDB in Taiwanese women across pregnancy areunknown. Whether Taiwanese populations may have different associations between SDBsymptoms and pregnancy outcomes than do American and European populations are largelyunexplored.The purpose of this three-year prospective longitudinal study is to: 1) develop and testthe predictive capacity of the Chinese version of the Berlin Questionnaire; 2) identify theincidence and risk factors for SDB and its symptoms in Taiwanese pregnant women acrosspregnancy; and 3) examine the association between SDB symptoms and pregnancy outcomesin Taiwanese women across pregnancy. The proposed study will include a total of 245pregnant women. Women recruited for this study will be assessed during the first, second, andthird trimester to examine the incidence and trajectory of SDB and its symptoms in womenacross pregnancy. Sleep patterns in women will be assessed objectively by actigraphy andsubjectively by self-administered questionnaires. Clinical data will be abstracted frommedical and delivery records. The 80 women recruited during the first year of the study willundergo full-night polysomnographic recordings to establish the predictive capacity of theChinese version of the Berlin Questionnaire. Data from the 165 women recruited during thesecond and third year of the study will be used to examine the incidence, severity, and riskfactors of SDB and its symptoms in pregnancy as well as to explore the association betweenSDB symptoms and pregnancy outcomes including labor duration and unplanned cesareansection rate.Analytic approaches to achieve the study purposes include descriptive statistics, receiveroperating characteristic curve analysis, and multiple linear and logistic regression analyses.Polysomnography scoring for sleep architectures and apneas/hypopneas will be performedaccording to the manual of American Academy of Sleep Medicine. Given the known negativehealth consequences of SDB, identifying women with high risks for SDB and referring themfor diagnosis and treatment will be clinically important because maternal physical healthinfluence fetal growth and development and may have implications for the long-term healthof the child. The risk factors identified from our study will inform clinical research andpractice and facilitate the development of future behavioral and treatment interventionstargeting the modifiable risk factors for reducing SDB and adverse pregnancy outcomes.睡眠睡眠呼吸障礙懷孕女性Pregnancysleepsleep disordered breathingwomen