孕期短睡眠时间与妊娠期糖尿病相关性的Meta分析

Short sleep duration during pregnancy and risk of gestational diabetes mellitus:a meta-analysis

目的系统回顾孕期短睡眠时间与妊娠期糖尿病(GDM)相关性研究,使用Meta分析探索二者的相关性,为孕期GDM预防提供依据。方法检索数据库有中国知网(CNKI)、维普、万方、中国生物医学文献服务系统(SinoMed)、Cochrane Library、Web of Science、Scopus、Embase、ProQuest、PubMed,检索时间为上述数据库建库至2021年1月,采用主题词检索法,共检索出636篇文献,结合纳入与排除标准,筛选文献、质量评价并提取资料。采用RevMan 5.3进行Meta分析。结果纳入15项研究,研究对象包括86532人,其中睡眠时间t<7h组的GDM发生率为18.96%,t≥7h组的GDM发生率17.87%。Meta分析显示t<7h组GDM发生风险高于t≥7h组(RR=1.59,95%CI:1.26~2.00,P<0.05)。亚组分析显示亚洲组孕妇睡眠时间t<7h组GDM发生风险高于t≥7h组(RR=1.60,95%CI:1.17~2.18,P<0.05),美洲组t<7h组GDM发生风险高于t≥7h组(RR=1.46,95%CI:1.12~1.91,P<0.05);队列研究显示孕妇睡眠时间t<7h组GDM发生风险高于t≥7h组(RR=1.54,95%CI:1.20~1.99,P<0.05),横断面调查研究显示t<7h组GDM发生风险高于t≥7h组(RR=2.10,95%CI:1.09~4.04,P<0.05)。各研究间敏感性稳定,发表偏倚小。结论妊娠期孕妇短睡眠时间是GDM发生的危险因素。

Objective Through systematical review of related studies in domestic and abroad on relationship between short sleep duration during pregnancy and risk of gestational diabetes mellitus(GDM),to explore the relationship in meta-analysis,so as to provide basis for primary prevention of GDM.Methods The networks such as CNKI,VIP,WanFang,SinoMed,Cochrane Library,Web of Science,Scopus,Embase,ProQuest and PubMed were searched from their inception until Jan.2021.The topic of subject word retrieval method was adopted.A total of 636 papers were obtained.According to the inclusion and exclusion criteria,the literature was screened,the quality was evaluated and then the data were extracted.Meta-analysis was conducted with RevMan 5.3.Results A total of 15 studies were selected,which involved 86532 pregnant women.The incidence of GDM was 18.96%in the sleep duration t<7h group,and 17.87%in the sleep duration t≥7h group.The meta-analysis demonstrated that the risk of GDM in thet<7h group was higher than that in the t≥7h group(RR=1.59,95%CI:1.26-2.00,P<0.05).Grouping analysis showed that the risk of GDM in the t<7h group in the Asian subgroup was higher than that in the t≥7h group(RR=1.60,95%CI:1.17-2.18,P<0.05),so did in the American subgroup(RR=1.46,95%CI:1.12-1.91,P<0.05),in the cohort study subgroup(RR=1.54,95%CI:1.20-1.99,0.05)and in the cross sectional study subgroup(RR=2.10,95%CI:1.09-4.04,P<0.05).The sensitivity was robust and the publication bias was weak.Conclusion Short sleep duration during pregnancy is a risk factor for GDM.