Objective: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on pregnancy outcomes, especially the relationship between OSAS and hypertensive disorders in pregnancy (HDP). Methods: A total of 228 pregnant women with high risk of OSAS who underwent sleep monitoring during pregnancy in Peking University People's Hospital from January 2021 to April 2022 were collected by reviewing their medical records for retrospective analysis. According to the diagnosis of OSAS, the pregnant women were divided into OSAS group (105 cases) and non-OSAS group (123 cases). The non-parametric Mann-Whitney U test, χ2 test or Fisher's exact test were used to compare the general data and maternal and fetal outcomes between the two groups, and the occurrence of each type of HDP was further compared. Results: (1) Compared with the non-OSAS group, the median pre-pregnancy body mass index (23.6 vs 27.6 kg/m2) and the proportion of snoring [28.9% (33/114) vs 59.2% (61/103)] in the OSAS group were higher, and the differences were both statistically significant (both P<0.001). (2) The incidence of HDP [67.6% (71/105) vs 39.0% (48/123)] and gestational diabetes mellitus [GDM; 40.0% (42/105) vs 26.8% (33/123)] of pregnant women in the OSAS group were higher than those in the non-OSAS group, and the median delivery week was shorter than that in the non-OSAS group (38.4 vs 39.0 weeks). The differences were all statistically significant (all P<0.05). Between-group differences for the delivery way, postpartum hemorrhage, the rate of intensive care unit admission, preterm birth, small for gestational age infants, neonatal asphyxia, the rate of neonatal intensive care unit admission, newborn birth weight and the proportion of umbilical artery blood pH<7.00 were not statistically significant (all P>0.05). (3) Compared with the non-OSAS group, the incidence of chronic hypertension [11.4% (14/123) vs 22.9% (24/105)] and chronic hypertension with superimposed pre-eclampsia [11.4% (14/123) vs 30.5% (32/105)] were higher in the OSAS group, and the differences were both statistically significant (both P<0.01). Conclusion: OSAS is related to HDP (especially chronic hypertension and chronic hypertension with superimposed pre-eclampsia) and GDM, which could provide a practical basis for the screening, diagnosis and treatment of OSAS in pregnant women at high risk.
目的： 探讨阻塞性睡眠呼吸暂停综合征（OSAS）对妊娠结局的影响，特别是与妊娠期高血压疾病（HDP）之间的关系。 方法： 选取2021年1月至2022年4月于北京大学人民医院建档、因OSAS高危于孕期行睡眠监测的孕妇228例作为观察对象，查阅病历收集其临床资料进行回顾性分析。根据是否确诊为OSAS，分为OSAS组（105例）和非OSAS组（123例），采用非参数Mann-Whitney U检验、χ2检验或Fisher精确概率法比较两组孕妇的一般资料和母儿结局，进一步对两组孕妇HDP各类型的发生情况进行比较。 结果： （1）与非OSAS组比较，OSAS组孕妇的中位孕前体重指数（分别为23.6、27.6 kg/m2）及打鼾症状的比例［分别为28.9%（33/114）、59.2%（61/103）］均较高，分别比较，差异均有统计学意义（P均<0.001）。（2）OSAS组孕妇HDP的发生率高于非OSAS组［分别为67.6%（71/105）、39.0%（48/123）］，妊娠期糖尿病（GDM）的发生率高于非OSAS组［分别为40.0%（42/105）、26.8%（33/123）］，OSAS组孕妇的中位分娩孕周低于非OSAS组（分别为38.4、39.0周），分别比较，差异均有统计学意义（P均<0.05）。非OSAS组和OSAS组孕妇的分娩方式、转入重症监护病房、产后出血、早产、小于胎龄儿、窒息、转入新生儿重症监护病房、脐动脉血气分析pH<7.00的比例、新生儿出生体重分别比较，差异均无统计学意义（P均>0.05）。（3）与非OSAS组比较，OSAS组孕妇妊娠合并慢性高血压［分别为11.4%（14/123）、22.9%（24/105）］、慢性高血压伴发子痫前期［分别为11.4%（14/123）、30.5%（32/105）］的发生率更高，分别比较，差异均有统计学意义（P均<0.01）。 结论： OSAS与HDP（尤其是妊娠合并慢性高血压及慢性高血压伴发子痫前期）和GDM有关，可为高危孕妇中开展OSAS的筛查和诊治提供一定的实践依据。.