妊娠早期睡眠质量与妊娠期糖尿病关系的探讨(1)
[摘要] 目的 通过调查孕妇孕早期睡眠状况，探讨其对妊娠期糖尿病的影响。 方法 选取沈阳市妇婴医院产科门诊657例孕早期妇女为研究对象，通过问卷调查收集孕妇基本信息、孕早期睡眠时间并了解睡眠质量情况。24～28孕周进行糖耐量筛查试验筛选出GDM孕妇。采用多因素非条件Logistics回归方法分析孕早期睡眠状况对妊娠期糖尿病发生率的影响。 结果 112例孕妇诊断为妊娠期糖尿病，孕早期有92例孕妇提示睡眠质量异常，睡眠障碍可以导致妊娠期糖尿病风险增加(OR=1.031，95%CI=1.027～1.115)。年龄、孕前BMI、孕早期睡眠质量及怀孕分娩次数均为妊娠期糖尿病发病的高危因素。 结论 孕早期睡眠质量差是妊娠期糖尿病发病的高危因素，孕早期对睡眠异常进行治疗可以减少妊娠期糖尿病的发病。
[关键词] 睡眠质量;妊娠期糖尿病;妊娠;早期
[中图分类号] R714.256 [文献标识码] B [文章编号] 1673-9701(2019)10-0062-04
Relationship between sleep quality in early pregnancy and gestational diabetes
ZHANG Yan WANG Xiaocai SUN Xiao
Department of Obstetrics， Shenyang Maternity and Infant Hospital， Shenyang 110011， China
[Abstract] Objective To explore the impact of sleep quality in early pregnancy on gestational diabetes. Methods A total of 657 pregnant women in the obstetrics clinic of our hospital were selected as the research subjects. The basic information of pregnant women， sleep time and sleep quality in early period of pregnancy were collected through questionnaires. Glucose tolerance screening tests were performed at 24-28 gestational weeks to screen out GDM pregnant women. Multivariate unconditional logistic regression analysis was used to analyze the effect of sleep status in early pregnancy on the incidence of gestational diabetes. Results 112 pregnant women were diagnosed with gestational diabetes， and 92 women in early pregnancy were indicated of abnormal sleep quality. Sleep disorders might lead to an increased risk of gestational diabetes(OR=1.031， 95%CI=1.027-1.115). Age， pre-pregnancy BMI， early pregnancy sleep quality and number of pregnancy and delivery were risk factors for gestational diabetes. Conclusion Poor sleep quality in early pregnancy is a high risk factor for gestational diabetes. Treatment of abnormal sleep during early pregnancy can reduce the incidence of gestational diabetes.
[Key words] Sleep quality; Gestational diabetes; Pregnancy; Early
妊娠期糖尿病(gestational diabetes mellitus，GDM)是指妊娠期发生或首次发现的任何程度的糖代谢异常[1]，不包括孕前已经诊断或已患糖尿病的患者。近年来随着生活水平的提高和生活习惯的改变，妊娠期糖尿病的发病率逐年增高，妊娠期糖尿病对母儿两代近远期均存在严重的影响，随着血糖的升高发生不良的妊娠结局，包括先兆子痫、胎膜早破、巨大儿以及新生儿低血糖等[2]情况随之增加，且远期容易造成母子两代高血压、2型糖尿病、肥胖及脂代谢紊乱[3-5]等。
激素的变化及早孕反应、尿频、胎動等生理原因影响孕期女性睡眠质量，且随孕周增长睡眠质量逐渐下降[6]。文献研究发现孕期睡眠障碍的发生率约为33%[7]。睡眠质量差可引起胰岛素敏感性下降，夜间糖皮质激素分泌增加，交感神经系统兴奋，瘦素分泌减少，造成葡萄糖耐量降低，从而可能诱发2型糖尿病[8-11]。虽有许多研究已证实孕期睡眠持续时间与妊娠期高血压和妊娠期糖尿病密切相关，目前对于睡眠质量与妊娠期糖尿病的研究较少，且结论不一致，Wang等[12]研究认为孕期睡眠障碍会增加妊娠期糖尿病的发病风险，Facco等[13]观察孕中期妇女后发现睡眠与妊娠期糖尿病发病毫无关联。, 百拇医药(张琰 王晓彩 孙晓)
[关键词] 睡眠质量;妊娠期糖尿病;妊娠;早期
[中图分类号] R714.256 [文献标识码] B [文章编号] 1673-9701(2019)10-0062-04
Relationship between sleep quality in early pregnancy and gestational diabetes
ZHANG Yan WANG Xiaocai SUN Xiao
Department of Obstetrics， Shenyang Maternity and Infant Hospital， Shenyang 110011， China
[Abstract] Objective To explore the impact of sleep quality in early pregnancy on gestational diabetes. Methods A total of 657 pregnant women in the obstetrics clinic of our hospital were selected as the research subjects. The basic information of pregnant women， sleep time and sleep quality in early period of pregnancy were collected through questionnaires. Glucose tolerance screening tests were performed at 24-28 gestational weeks to screen out GDM pregnant women. Multivariate unconditional logistic regression analysis was used to analyze the effect of sleep status in early pregnancy on the incidence of gestational diabetes. Results 112 pregnant women were diagnosed with gestational diabetes， and 92 women in early pregnancy were indicated of abnormal sleep quality. Sleep disorders might lead to an increased risk of gestational diabetes(OR=1.031， 95%CI=1.027-1.115). Age， pre-pregnancy BMI， early pregnancy sleep quality and number of pregnancy and delivery were risk factors for gestational diabetes. Conclusion Poor sleep quality in early pregnancy is a high risk factor for gestational diabetes. Treatment of abnormal sleep during early pregnancy can reduce the incidence of gestational diabetes.
[Key words] Sleep quality; Gestational diabetes; Pregnancy; Early
妊娠期糖尿病(gestational diabetes mellitus，GDM)是指妊娠期发生或首次发现的任何程度的糖代谢异常[1]，不包括孕前已经诊断或已患糖尿病的患者。近年来随着生活水平的提高和生活习惯的改变，妊娠期糖尿病的发病率逐年增高，妊娠期糖尿病对母儿两代近远期均存在严重的影响，随着血糖的升高发生不良的妊娠结局，包括先兆子痫、胎膜早破、巨大儿以及新生儿低血糖等[2]情况随之增加，且远期容易造成母子两代高血压、2型糖尿病、肥胖及脂代谢紊乱[3-5]等。
激素的变化及早孕反应、尿频、胎動等生理原因影响孕期女性睡眠质量，且随孕周增长睡眠质量逐渐下降[6]。文献研究发现孕期睡眠障碍的发生率约为33%[7]。睡眠质量差可引起胰岛素敏感性下降，夜间糖皮质激素分泌增加，交感神经系统兴奋，瘦素分泌减少，造成葡萄糖耐量降低，从而可能诱发2型糖尿病[8-11]。虽有许多研究已证实孕期睡眠持续时间与妊娠期高血压和妊娠期糖尿病密切相关，目前对于睡眠质量与妊娠期糖尿病的研究较少，且结论不一致，Wang等[12]研究认为孕期睡眠障碍会增加妊娠期糖尿病的发病风险，Facco等[13]观察孕中期妇女后发现睡眠与妊娠期糖尿病发病毫无关联。, 百拇医药(张琰 王晓彩 孙晓)