Use of PAP in women with pre-eclampsia

PAP 在先兆子痫女性中的应用

基本信息

批准号：
8214567
负责人：
LOUISE M O'BRIEN
金额：
$ 11.7万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-06-01 至 2014-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8214567
关键词：
Admission activity Adult Affect Apgar Score Blood Pressure Blood Pressure Monitors Cessation of life Chronic Consent Continuous Positive Airway Pressure Data Disease Eclampsia Enrollment Frequencies Goals Health High-Risk Pregnancy Hypertension Incidence Infant Instruction Measures Medical Records Monitor Morbidity - disease rate Mothers Neonatal Intensive Care Neonatal Intensive Care Units Newly Diagnosed Outcome Patient Care Patients Pattern Physiological Play Polysomnography Pre-Eclampsia Pregnancy Pregnancy Complications Pregnant Women Principal Investigator Proteinuria Randomized Controlled Clinical Trials Reporting Research Risk Factors Role Severities Sleep Sleep Apnea Syndromes Snoring Symptoms Time Weight Gain Woman Women&apos s Group abstracting comparison group fetal improved in utero infant outcome instrumentation novel pregnant pressure standard care

项目摘要

DESCRIPTION (provided by applicant): Pre-eclampsia is a pregnancy-specific disorder characterized by hypertension and proteinuria observed after the 20th week of gestation. It affects 5-8% of U.S. pregnancies, is a precursor for potentially fatal eclampsia, and is a leading global cause of maternal and infant morbidity. The incidence of pre-eclampsia has increased by nearly one-third over the past decade and hypertensive disorders during pregnancy are now responsible for at least 76,000 U.S. deaths each year. The cause of pre-eclampsia and its rising incidence remain uncertain. However, several lines of evidence suggest that sleep-disordered breathing (SDB) could play a role. SDB is common, most often undiagnosed - especially in women - and treatable. Snoring, the hallmark symptom of SDB, is more frequent during pregnancy. Increased weight promotes SDB, and significant weight gain or other physiological changes during pregnancy also may exacerbate SDB. SDB has been associated with elimination or reversal of normal nocturnal dips in blood pressure (BP), similar to BP patterns observed in pre-eclampsia. Of note, SDB is a known independent risk factor for hypertension in non-pregnant adults but it is unknown if SDB in pregnant women contributes to pre-eclampsia. Treatment of SDB with CPAP has been shown to ameliorate nocturnal BP increases in hypertensive patients with SDB, but not in hypertensive patients without SDB. No study has determined whether SDB does in fact increase nocturnal BP during pregnancy and whether SDB promotes pre-eclampsia remains unproven. Therefore, the main goals of this research are to identify whether SDB - as measured by overnight polysomnography - is associated with pre-eclampsia, to confirm that use of auto-titrating positive airway pressure (auto-PAP) can improve nocturnal BP, and to determine whether any such effect depends on the presence of underlying SDB. Moreover, we will show that such improvement in nocturnal BP will be associated with improved maternal daytime BP and improved fetal outcome, as measured by more days in utero and fewer admissions to the neonatal intensive care unit. RELEVANCE (See instructions): This novel research will show that treatment of sleep-disordered breathing in women with pre-eclampsia - a serious complication of pregnancy - will reduce maternal blood pressure which will, in turn, result in improved health for mothers and babies. (End of Abstract)

描述（由申请人提供）：审核前是一种妊娠特异性疾病，其特征是妊娠20周后观察到的高血压和蛋白尿。它影响了5-8％的美国怀孕，是潜在致命的子痫的先驱，并且是母亲和婴儿发病率的全球主要原因。在过去的十年中，前宾夕化前的发生率增加了近三分之一，而怀孕期间的高血压疾病现在每年至少造成76,000名美国死亡。子痫前期及其发病率上升的原因仍不确定。但是，有几条证据表明睡眠呼吸呼吸（SDB）可以发挥作用。 SDB很常见，通常未诊断，尤其是在女性中 - 可以治疗。打nor是SDB的标志性症状，在怀孕期间更常见。体重增加会促进SDB，怀孕期间的显着体重增加或其他生理变化也可能加剧SDB。 SDB与血压（BP）正常夜间下降（BP）的消除或逆转相关，类似于益酮前观察到的BP模式。值得注意的是，SDB是非妊娠成年人高血压的已知独立危险因素，但孕妇中的SDB是否有助于前宾夕法尼亚前的SDB。 SDB用CPAP的治疗已显示可改善SDB高血压患者的夜间BP的增加，但没有SDB的高血压患者。尚无研究确定SDB在怀孕期间是否确实增加了夜间BP，以及SDB是否促进子痫前期仍然未经证实。因此，这项研究的主要目标是确定通过隔夜多渗透学测量的SDB是否与前宾夕法尼亚前启示识别有关，以确认使用自动互动阳性气道压力（AUTO-PAP）是否可以改善夜间BP，并确定任何此类效应是否取决于基础SDB的存在。此外，我们将表明，夜间BP的这种改善将与孕妇白天的BP改善和改善的胎儿结局有关，如子宫内的更多天数，对新生儿重症监护病房的入院率更少。相关性（请参阅说明）：这项新的研究将表明，接受前宾夕法尼亚前女性的睡眠呼吸呼吸 - 严重的怀孕并发症 - 将降低母亲的血压，从而减少母亲和婴儿的健康状况。（抽象的结尾）