Sleep Disturbance and risk for adverse pregnancy outcomes

睡眠障碍和不良妊娠结局的风险

• 批准号: 8264972
• 负责人: William Adam Grobman
• 金额: $ 64.51万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8264972
• 关键词: Address; Affect; Cardiovascular Diseases; Cardiovascular Pregnancy Complications; Cardiovascular system; Characteristics; Data; Desire for food; Development; Diabetes Mellitus; Disease; Environmental Risk Factor; Epidemiologic Studies; First Pregnancy Trimester; Future; General Population; Gestational Diabetes; Health; Hormones; Hypertension; Hypertension induced by pregnancy; Inflammation; Link; Measures; Medical; Mental disorders; Metabolic; Metabolic Diseases; Outcome; Patient Self-Report; Pattern; Physiological; Population; Pre-Eclampsia; Pregnancy; Pregnancy Outcome; Pregnant Women; Prevalence; Prospective Studies; Psychosocial Factor; Questionnaires; Research; Resources; Restless Legs Syndrome; Risk; Screening procedure; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep Fragmentations; Sleep disturbances; Sleeplessness; Surveys; Testing; Third Pregnancy Trimester; Woman; actigraphy; base; clinical care; cohort; fetal; improved; insulin sensitivity; mortality; obesity risk; population based; pregnant; public health relevance; research study; sleep abnormalities

DESCRIPTION (provided by applicant): Sleep disturbances are common in the general population, and women are a population at particular risk. Recent studies indicate a link between short sleep duration and sleep disturbances with adverse health risks. Evidence from physiological and epidemiological studies demonstrate an association between short sleep duration and an increased risk of obesity, diabetes, hypertension, and mortality. In addition, specific sleep disorders, in particular sleep disordered breathing have been linked with cardiovascular and metabolic disorders. Despite the emerging evidence of the importance of sleep for health and data that sleep disturbances are common among pregnant women, there is a paucity of research on the potentially important link between sleep and maternal/ fetal outcomes, particularly metabolic and cardiovascular complications of pregnancy. Specifically, there is limited data on how insufficient sleep and sleep disorders may contribute to the development of gestational diabetes, gestational hypertension, and preeclampsia. We have identified a unique and timely opportunity to leverage the resources of the recently established Nulliparous Research Network of 10,000 pregnant women to address the relationship between sleep abnormalities (short sleep duration, poor sleep quality and common sleep disorders) and pregnancy outcomes. The overall hypothesis to be tested is that sleep disturbances are associated with an increase risk for cardiometabolic disorders during pregnancy. Specifically this application proposes to evaluate self-reported and objective sleep/wake characteristics in a large cohort of pregnant women from whom detailed cardiovascular and metabolic pregnancy outcomes will be measured from the first trimester to delivery. The specific aims are: 1) To systematically characterize sleep patterns using survey and actigraphy in a large cohort of pregnant women; 2) To determine the relationships between abnormal sleep patterns (sleep quality and sleep disorders) and cardiovascular and metabolic disorders of pregnancy (gestational hypertension, preeclampsia, gestational diabetes); 3) To determine concordance between self-reported measures of sleep and objectively derived sleep measures (using actigraphy) in a pregnant population. This application will provide the first large scale longitudinal assessment of sleep in a pregnant population and determine the relationship between sleep characteristics and disorders with pregnancy outcomes. The results of this study have the potential to inform and change clinical care to improve pregnancy outcomes. PUBLIC HEALTH RELEVANCE: Disturbed sleep is common among pregnant women and few studies have evaluated sleep in pregnancy or examined maternal and fetal outcomes in women with sleep disturbances. Given the link between sleep disturbances and metabolic and cardiovascular complications, of which pregnant women are at particular risk, there is a great need for such a study. The current application will seize the unique opportunity to leverage the resources of the recently established Nulliparous Research Network to study the relationship between sleep abnormalities and pregnancy outcomes; specifically this application proposes to evaluate self-reported and objective sleep/wake characteristics in a large cohort of pregnant women from whom detailed cardiovascular and metabolic pregnancy outcomes will be measured. This study will form the basis for future studies to determine whether screening for and treatment of sleep disturbances during pregnancy is an effective strategy to improve pregnancy outcomes.

描述（由申请人提供）：睡眠障碍在普通人群中很常见，女性是处于特殊风险的人群。最近的研究表明，短睡眠时间与睡眠障碍与不利的健康风险之间有联系。生理和流行病学研究的证据表明，短睡眠持续时间与肥胖，糖尿病，高血压和死亡率的风险增加之间存在关联。此外，特定的睡眠障碍，尤其是睡眠失调的呼吸与心血管和代谢障碍有关。尽管有新的证据表明睡眠对健康和数据的重要性在孕妇中很常见，但对于睡眠与孕产妇/胎儿结局之间的潜在重要联系，尤其是妊娠的代谢和心血管并发，仍有很少的研究。具体而言，关于睡眠和睡眠障碍如何有助于妊娠糖尿病，妊娠高血压和先兆子痫的发展的数据有限。 我们已经确定了一个独特而及时的机会，可以利用最近建立的10,000名孕妇的无效研究网络的资源来解决睡眠异常之间的关系（睡眠时间短，睡眠质量差和常见的睡眠障碍）和妊娠结局。总体假设要测试的是，睡眠障碍与怀孕期间心脏代谢疾病的风险增加有关。具体而言，该申请建议在大量孕妇中评估自我报告和客观的睡眠/唤醒特征，这些孕妇将从第一学期到分娩详细的心血管和代谢妊娠结局。具体目的是：1）系统地使用大量孕妇的调查和行为来制定睡眠模式； 2）确定异常睡眠模式（睡眠质量和睡眠障碍）与妊娠的心血管和代谢障碍之间的关系（妊娠高血压，先兆子痫，妊娠糖尿病）； 3）确定在孕妇人群中自我报告的睡眠措施与客观衍生的睡眠度量（使用行为）之间的一致性。该应用将在怀孕人群中对睡眠的第一个大规模纵向评估，并确定睡眠特征与妊娠结局的疾病之间的关系。这项研究的结果有可能告知和改变临床护理以改善妊娠结局。 公共卫生相关性：孕妇中的睡眠障碍很常见，很少有研究在妊娠中评估睡眠或患有睡眠障碍的妇女的母亲和胎儿结局。鉴于睡眠障碍与代谢和心血管并发症之间的联系，孕妇特别风险，因此非常需要进行此类研究。当前的应用程序将抓住独特的机会来利用最近建立的无效研究网络的资源来研究睡眠异常与妊娠结局之间的关系；具体而言，该应用建议在大量孕妇中评估自我报告和客观的睡眠/唤醒特征，这些孕妇将通过这些孕妇进行详细的心血管和代谢妊娠结局。这项研究将构成未来研究的基础，以确定怀孕期间睡眠障碍的筛查和治疗是否是改善妊娠结局的有效策略。