Pregnancy-Related Sleep Disturbances May Increase Pregnancy Complications

与怀孕相关的睡眠障碍可能会增加怀孕并发症

基本信息

批准号：
7777103
负责人：
MICHELE L OKUN
金额：
$ 24.53万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
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 2012-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7777103
关键词：
Address Age Area Attention Behavioral Blood Communities Complication Development Discipline of obstetrics Enrollment Ethnic Origin Fetal Growth Retardation Future Health behavior Hospitals Incidence Infant Inflammation Inflammatory Response Investigation Literature Maternal Age Medical Methods Modeling Morbidity - disease rate Nature Neurologic Participant Pathogenesis Pathway interactions Pre-Eclampsia Pregnancy Pregnancy Complications Pregnancy Outcome Pregnancy Trimesters Pregnant Women Premature Birth Probability Psychopathology Psychosocial Stress Public Health Questionnaires Recording of previous events Research Research Design Risk Risk Factors Sampling Sleep Sleep disturbances Techniques Time Transportation Universities Woman base case control cohort demographics design diaries experience inflammatory marker mortality psychosocial respiratory statistics

项目摘要

Adverse pregnancy outcomes increase a woman's risk of future medical morbidities and place her infant at risk of developmental, neurological and respiratory abnormalities, as well as increased mortality. Despite the investigation of the various behavioral and psychosocial contributors a large portion of the variance in the pregnancy course remains unexplained. A growing literature shows that sleep disruption is associated with increased medical morbidity. It is widely accepted that pregnancy is associated with the disruption of sleep (3- 5). Despite this evidence, the nature and extent of this disruption remains to be determined. Recent attention has focused on evidence that systemic inflammation is involved in the pathogenesis of pregnancy complications (23). Thus, it is reasonable to propose a conceptual model where pathological disruption of sleep during early pregnancy results in systemic inflammation that contributes to risk of pregnancy complications. Likewise, it is also reasonable to propose that increased systemic inflammation contributes to increased sleep disruption observed during early pregnancy thereby contributing to increased risk of pregnancy complications. In the current proposal, we propose the first longitudinal examination of this pathophysiologic and bi-directional pathway that may contribute to risk of pregnancy complications. The following aims will be addressed: Aim 1. Characterize sleep disturbances in both complicated and uncomplicated pregnancies. Aim 2. Examine the relationship between sleep and circulating inflammatory markers during early pregnancy .Aim 3. Explore the association between sleep-related increases in proinflammatory markers and pregnancy complications. In order to answer these research questions a cohort of 400 women will be seen around 10 weeks gestation and seen twice more at ~14 weeks and ~18 weeks gestation. Participants will complete a sleep diary and wear an actigraph watch for a 2-week period. At the end of each 2-week period, participants will complete a battery of questionnaires, then have blood and physical information collected. Descriptive statistics will be used for Aim 1. A nested case-control design will be used to analyze the independent and djmamic effects of sleep and inflammation on the risk of pregnancy complications (Aims 2 and 3).

不良妊娠结局会增加女性未来罹患疾病的风险，并使婴儿面临风险发育、神经和呼吸系统异常，以及死亡率增加。尽管对各种行为和社会心理影响因素的调查，很大一部分差异在于怀孕过程仍无法解释。越来越多的文献表明，睡眠障碍与医疗发病率增加。人们普遍认为怀孕与睡眠中断有关（3- 5）。尽管有这些证据，但这种破坏的性质和程度仍有待确定。近期关注重点关注全身炎症参与妊娠并发症发病机制的证据 (23)。因此，提出一个概念模型是合理的，该模型将早期睡眠的病理性破坏怀孕会导致全身炎症，从而增加妊娠并发症的风险。同样，它是也有理由认为全身炎症的增加会导致睡眠中断的增加在怀孕早期观察到，从而导致妊娠并发症的风险增加。在目前的建议，我们建议对这种病理生理学和双向的第一次纵向检查可能导致妊娠并发症风险的途径。将实现以下目标：目标 1。描述复杂和简单妊娠中睡眠障碍的特征。目标 2. 检查妊娠早期睡眠与循环炎症标志物之间的关系。目标 3. 探索睡眠相关的促炎标记物增加与妊娠并发症之间的关联。为了为了回答这些研究问题，我们将在妊娠 10 周左右对 400 名女性进行观察并进行观察在妊娠约 14 周和约 18 周时再进行两次。参与者将完成睡眠日记并佩戴 actigraph 手表为期 2 周。每两周结束时，参与者将完成一系列问卷，然后收集血液和身体信息。目标 1 将使用描述性统计。将使用嵌套病例对照设计来分析睡眠和睡眠的独立和动态影响。炎症对妊娠并发症风险的影响（目标 2 和 3）。