Maternal Sleep and Sleep Disturbance in Relation to the Developing Fetus

母亲睡眠和睡眠障碍与胎儿发育的关系

• 批准号: 9107889
• 负责人: Janet A. Di Pietro
• 金额: $ 55.18万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-07 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9107889
• 关键词: Acute; Affect; Attention; Brain; Cardiac; Case Study; Characteristics; Chronic; Clinical; Clinical Management; Coupling; Data; Data Set; Deceleration; Detection; Development; Disease; Documentation; Electrocardiogram; Environment; Fetal Development; Fetal Distress; Fetal Growth; Fetal Heart Rate; Fetus; Gestational Diabetes; Goals; Health; Human; Life; Link; Measurement; Measures; Metabolism; Methods; Monitor; Motor Activity; Nervous system structure; Neurologic; Obesity; Obstructive Sleep Apnea; Participant; Patient Self-Report; Pattern; Perception; Physiological; Physiology; Polysomnography; Positioning Attribute; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Premature Birth; Process; Research; Residual state; Risk; Risk Factors; Role; Sampling; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Staging; Technology; Time; Translating; Ursidae Family; Variant; Wakefulness; Woman; adverse pregnancy outcome; base; fetal; fetal programming; forging; heart rate variability; interest; neurobehavioral; neurodevelopment; obesogenic; offspring; postnatal; prenatal; programs; response

DESCRIPTION (provided by applicant): Sleep disorders are common in pregnancy and disturbances to maternal sleep adversely affect pregnancy outcomes. Maternal sleep comprises, on average, 87 days of a full term pregnancy yet little is known about the role of normal or disordered sleep on the developing fetus. Our objective is to bring measurement of the fetus, using leading edge technologies which include the recent advancement in procuring fetal electrocardiogram (ECG) data in the antepartum, to the field of pregnancy sleep research. We propose that the fetus reacts to the physiological changes that accompany normal and that disordered maternal sleep and chronic sleep disturbances have persistent effects on fetal neuromaturation. To evaluate this premise, we will a) record fetal ECG continuously during nocturnal maternal sleep at 28 weeks gestation while participants are undergoing polysomnography, and b) record fetal neuromaturation indicators during daytime maternal wakefulness at 28 and 36 weeks gestation to evaluate functioning in relation to polysomnography-detected sleep disordered breathing and self-report of habitual sleep characteristics in a sample of 130 obese pregnant women. Fetal neuromaturation measures include fetal heart rate and variation, motor activity, and somatic- cardiac coupling. We focus on obese women because, while sleep disordered breathing has been shown to exert additional independent risk to pregnancy outcomes above that conferred solely by obesity, obesity is the primary risk factor for obstructive sleep apnea and other sleep disturbances in pregnancy. We predict that: 1. obstructive sleep apnea as well as milder forms of sleep disordered breathing will be contemporaneously associated with decelerations in fetal heart rate and reduction in heart rate variability during the night; 2. fetal heart rate and its derivatives will vary by maternal slep stage; 3. sleep disordered breathing will have residual effects on fetal neuromaturation that will be evident in daytime recordings during maternal wakefulness; and 4. maternal perception of sleep quality and disruption will be reflected in alterations to fetal neuromaturation between 28 and 36 weeks gestation. This project will forge an interdisciplinary team of technical and clinical expertise with long-standing independent research programs on both sleep in pregnancy and fetal neurodevelopment. Results will provide new information on the interface between maternal sleep and fetal neurological development and will have implications for clinical management of pregnancy with respect to both sleep disorders and obesity. If successful, we hope these findings will generate a new and productive avenue of inquiry regarding the potential fetal programming effects of disordered maternal sleep as well as essential understanding of the interface between maternal sleep and fetal functioning.

描述（由申请人提供）：睡眠障碍在妊娠中很常见，并且对母亲睡眠的障碍对妊娠结局产生了不利影响。孕产妇的睡眠平均包括全学期怀孕的87天，但对于正常睡眠或无序睡眠在发育中的胎儿中的作用知之甚少。我们的目标是使用前缘技术进行胎儿的测量，其中包括最近在天前的采购胎儿心电图（ECG）数据的进步，到妊娠睡眠研究领域。我们建议胎儿对伴随正常的生理变化以及孕产妇睡眠和慢性睡眠障碍对胎儿神经饱和的持续影响。为了评估这一前提，我们将a）在妊娠28周的夜间孕产妇睡眠期间连续记录胎儿ECG，而参与者正在经历多个胎儿术，b）在28和36周的孕妇妊娠期间，胎儿神经饱和指标的胎儿神经饱和指标在妊娠期孕妇的妊娠期，以评估与妇女的习惯性临时和习惯性地相关的习惯性，并习惯性地习惯性地习惯性地习惯性地习惯性地习惯性地培养自我习惯，以自我习惯习惯性地进行自我培养。胎儿神经饱和度措施包括胎儿心率和变异，运动活动和体细胞耦合。我们专注于肥胖女性，因为尽管呼吸呼吸困扰，但已显示出对仅由肥胖赋予的妊娠结局施加额外的独立风险，但肥胖是阻塞性睡眠呼吸暂停的主要危险因素和怀孕期间其他睡眠障碍。我们预测：1。阻塞性睡眠呼吸呼吸暂停以及呼吸的温和形式的呼吸 与胎儿心率下降和夜间心率变异性的降低相关； 2。胎儿心率及其衍生物将因母体SLEP阶段而异。 3。睡眠无序的呼吸对胎儿神经饱和的残留影响，这在孕产妇清醒期间的白天记录中很明显； 4。对睡眠质量和破坏的孕产妇感知将反映在28至36周之间对胎儿神经饱和的改变。该项目将建立一个跨学科的技术和临床团队 长期存在有关妊娠睡眠和胎儿神经发育的独立研究计划的专业知识。结果将提供有关孕产妇睡眠与胎儿神经系统发育之间界面的新信息，并将对妊娠的临床治疗产生影响。如果成功的话，我们希望这些发现将为无序孕产妇睡眠的潜在胎儿编程影响以及对孕产妇睡眠和胎儿功能之间的界面的基本理解而产生新的富有成效的探究途径。