孕期打鼾对不同妊娠期妇女的影响

The pathological effect of snoring on pregnant women

目的 探讨孕期打鼾对不同妊娠期妇女的病理影响.方法 选择2006年1月至2008年2月在温州医学院附属第二医院产科门诊建卡登记并分娩的孕妇601例,年龄范围19～41岁,于妊娠第13周、28周及分娩前问卷调查睡眠打鼾情况、测量孕妇生理生化指标,记录妊娠期并发症和妊娠结局.根据妊娠时间及打鼾情况,分为打鼾组与非打鼾组,并将打鼾组细分为孕早期打鼾组、孕中期打鼾组、孕晚期打鼾组.结果 与非打鼾组比较,打鼾组孕妇体重指数、腹围及颈围在孕早、中、晚期均明显增加,差异有统计学意义（均P〈0.05）.臀围及收缩压在孕早期无变化,孕中期、晚期明显增加（P〈0.05）,舒张压在孕早、中期无变化（P〉0.05）,孕晚期明显增加,差异有统计学意义（P〈0.05）.打鼾组内早产发生率比较差异无统计学意义（P〈0.05）.孕早、中期打鼾组剖宫产及妊娠高血压综合征发生率均明显高于非打鼾组,差异有统计学意义（P〈0.05）,孕晚期打鼾组和非打鼾组比较,差异无统计学意义（P〉0.05）,孕早期和孕中期打鼾组比较无统计学差异,但均高于孕晚期打鼾组,差异有统计学意义（P〈0.05）.孕期打鼾是妊娠高血压综合征发生的危险因素,孕早期、中期打鼾是早产和剖宫产的危险因素.各孕期打鼾组孕妇妊娠高血压综合征、早产、剖宫产发生率较非打鼾组均明显增加,差异有统计学意义（均P〈0.05）,打鼾组间两两比较差异无统计学意义（P〉0.05）.结论 孕期打鼾使孕妇生理特点发生变化,妊娠高血压综合征、早产、剖宫产的发生率增加,应重视打鼾孕妇的围产期保健.

Objective To discuss the pathological effect of snoring on pregnant women in Wenzhou area. Methods The study was performed between January 2006 and February 2008, 601 women with pregnancies being in clinic or the ward were surveyed about snoring occur, measuring physiological and biochemical parameters in the 13th, 28th week of pregnancy and before delivery, recording the complication and pregnancy outcome. According to their pregnancy and snoring occur, they were divided into the first, the second and the third trimester snoring group and non-snoring group. Result Compared with the non-snoring group,The BMI, abdominal perimeter, the neck circumference and systolic blood pressure in snoring group of every trimester increased significantly（P 〈 0. 05 ）. There were no significant differences about the hip circumference of snoring group in the first trimester（P 〉 0. 05 ）, but they increased significantly in the second and the third trimester（P 〈 0. 05 ）. There were no significant differences about the diastolic blood pressure of snoring group in the first and the second trimester（P 〉 0. 05）, but they increased significantly in the third trimester（P 〈 0. 05 ）. There were no significant differences about the snoring group＇s BMI,abdominal perimeter, the neck circumference, the hip circumference and blood pressure between the groups of every trimester（P 〉 0. 05 ）. Compared with the non-snoring group, the incidence of snoring group＇s gestational hypertension, premature birth and abdominal delivery increased significantly every trimester of pregnancy（P 〈0. 05）. There were no significant differences Between the snoring groups of every trimester （P 〉 0. 05）. Conclusion The snore makes pregnant women physiological characteristics changed, the incidence of gestational hypertension, premature delivery and abdominal delivery increased. So we should pay more attentions to them in their perinatal stage.