合肥市孕妇孕晚期睡眠状况与心血管病10年风险的关联

Relationship between sleep of late trimester pregnant women and 10-year risk of cardiovascular disease in Hefei City

目的 探讨孕晚期睡眠状况与心血管病10年风险之间的关联。方法 于2015年3月至2020年7月,在合肥市3家医院产科门诊招募孕28-40周、年龄为18-45岁的单胎妊娠孕妇3034名。问卷调查收集一般人口学特征、生活行为、睡眠状况等信息。采集空腹静脉血,检测血清总胆固醇与高密度脂蛋白胆固醇。运用限制性立方样条回归模型、Logistic回归和分层分析,探索睡眠状况与心血管病10年风险的关联。结果 孕晚期孕妇睡眠时长为(7.6±1.1)h,就寝时间≥22:00的比例为82.7%,睡眠中点≥02:30的比例为66.4%,晨醒时间≥07:00的比例为57.6%。心血管病10年风险率为(2.03±1.86)%,其中高危者占10%(303例)。限制性立方样条回归结果显示,睡眠时长、睡眠中点和晨醒时间与心血管病10年风险的关联呈下降趋势(P<0.001)。Logistic回归分析结果显示,睡眠时长小于8 h、晨醒时间在07:00前和睡眠中点在02:30前的孕妇,心血管病10年风险为高危者的比例显著增加(OR=1.35,95%CI 1.05-1.75;OR=2.23,95%CI 1.71-2.90;OR=1.63,95%CI 1.26-2.11)。进一步分层分析显示,仅在22:00后就寝的孕妇人群中,睡眠时长小于8 h、晨醒时间在07:00前和睡眠中点在02:30之前的孕妇,其心血管病10年风险为高危者的比例显著增加(OR=1.53,95%CI 1.14-2.05;OR=2.44,95%CI 1.81-3.28;OR=1.85,95%CI 1.37-2.50)。结论 孕晚期就寝时间迟于22点的孕妇,睡眠时长小于8 h、07:00前醒来或睡眠中点在02:30之前可增加心血管病10年风险。

OBJECTIVE To explore the relationship between maternal sleep in the third trimester and 10-year risk of cardiovascular disease(CVD).METHODS From March 2015 to July 2020, a total of 3034 pregnant women aged 18 to 45 years old with single pregnancy at the gestational age of 28 to 40 weeks in 3 hospitals in Hefei were enrolled in the study. Questionnaire survey was conducted to collect general demographic characteristics, lifestyles and sleep status. Total cholesterol(TC) and high-density lipoprotein cholesterol(HDL-C) were measured in venous blood. Restricted cubic spline regression model, Logistic regression model and stratified analysis were used to explore the association between sleep status and 10-year CVD risk.RESULTS In the third trimester, the average sleep duration was(7.6±1.1) hours and the proportion of bedtime ≥22:00 was 82.7%. Sleep midpoint ≥02:30 accounted for 66.4% and wake up ≥07:00 accounted for 57.6%. The 10-year CVD risk prediction was(2.03±1.86)% and high-risk accounted for 10%(303 cases). In the restricted cubic spline regression, night sleep duration, bedtime, and getup with 10-year CVD risk had a downward trend(P<0.001). Logistic regression model result showed that short sleep duration(less than 8 hours) and wake up early(before 07:00 o’clock) and sleep midpoint before 02:30 was associated with a significantly higher 10-year CVD risk(OR=1.35,95%CI 1.05-1.75;OR=2.23,95%CI 1.71-2.90;OR=1.63,95%CI 1.26-2.11). Further stratified analysis found that only among pregnant women with later bedtime(after 22:00 o’clock), short sleep duration(less than 8 hours) and wake up early(before 07:00 o’clock) and sleep midpoint before 02:30 was associated with significantly increased 10-year CVD risk(OR=1.53,95%CI 1.14-2.05;OR=2.44,95%CI 1.81-3.28;OR=1.85,95%CI 1.37-2.50).CONCLUSION In the third trimester, exposure to shorter sleep duration(less than 8 hours) or wake up early(before 07:00 o’clock) or sleep midpoint before 02:30 may increase the risk of 10-year CVD risk, in particular, for the pregnant women later bedtime(after 22:00 o’clock).