青海地区孕晚期女性阻塞性睡眠呼吸暂停与妊娠并发症相关性分析

Analysis on the Correlation between OSAHS and Pregnancy Complications in Women in the Third Trimester of Pregnancy in Qinghai Province

目的:研究青海地区妊娠晚期OSAHS与产时并发症的关系。方法:收集2018年1月—2019年2月于我院妇产科常规入院准备临产孕妇82例,对82例患者数据AHI分为四组:正常组、轻度OSAHS组、中度OSAHS组、重度OSAHS组,同期对所有孕妇进行EPO,TNF-a、IL-6化验检查。结果:①正常组、轻度OSAHS组、中度OSAHS组、重度OSAHS组妊娠期高血压的发病率分别为:9.1%、8.3%、3.6%、50.0%,四组妊娠期子痫的发病率分别为:0、8.3%、0、25.0%,四组妊娠期糖尿病的发病率分别为:9.1%、16.7%、14.3%、75.0%,四组低体重出生儿的发生率分别为:0、4.2%、17.9%、37.5%;且各组差异具有统计学意义(P<0.05);②AHI与各项指标的相关性分析显示:AHI与孕期体重增加呈正相关(r=0.741,P<0.05),AHI与孕期BMI增加呈正相关(r=0.862,P<0.05),AHI与浅熟睡时间呈正相关(r=0.731,P<0.05),AHI与肿瘤坏死因子呈正相关(r=0.421,P<0.05);③孕期BMI增长与各项指标的相关性分析显示:孕期BMI增加与浅睡时间呈正相关(r=0.713,P<0.05),孕期BMI增长与肿瘤坏死因子呈正相关(r=0.453,P<0.05)。结论:高原孕晚期女性OSAHS发生率较高;在高原孕晚期女性OSAHS的发生会增加妊娠高血压、妊娠期子痫、妊娠期糖尿病以及体重出儿的发生风险;关注孕晚期女性孕期体重增长将有助于早期发现妊娠期OSAHS发生。

Objective:This analysis is aimed to study the relationship between OSAHS in late pregnancy and complications in labor in Qinghai.Methods:From January 2018 to February 2019,82 pregnant women who were admitted to our hospital for labor were collected and divided into four groups according to the Apnea Hypopnea index(AHI):normal group,mild obstructive sleep apnea hypopnea syndrome(OSAHS)group,moderate OSAHS group and severe OSAHS group,while testing their tumor necrosis factor-A(TNF-a)and interleukin-6(IL-6).Results:Incidence rates of hypertension in normal group,mild OSAHS group,moderate OSAHS group and severe OSAHS group were9.1%,8.3%,3.6%and 50.0%respectively.Incidence rates of eclampsia in four groups were 0,8.3%,0 and 25.0%respectively.Incidence rates of gestational diabetes in four group were 9.1%,16.7%,14.3%,75.0%and incidence rates of low birth weight were 0,4.2%,17.9%,and 37.5%respectively.The difference was statistically significant(P<0.05).The correlating analysis between AHI and various indexes showed that AHI was positively correlated with weight gain during pregnancy(r=0.741,P<0.05),with BMI during pregnancy(r=0.862,P<0.05),with shallow ripening time(r=0.731,P<0.05),and with tumor necrosis factor(r=0.421,P<0.05).The correlation analysis between BMI growth in pregnancy and various indexes showed that BMI growth in pregnancy was positively correlated with light ripening time(r=0.713,P<0.05),and BMI growth in pregnancy was positively correlated with tumor necrosis factor(r=0.453,P<0.05).Conclusion:The incidence of OSAHS is high in the high altitude area,which may increase the risk of pregnancy hypertension,eclampsia,diabetes mellitus and birth weight.Paying attention to the weight growth in the late pregnancy will help to detect the occurrence of OSAHS in the early stage.