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目的探讨孕期打鼾对胎儿宫内生长发育的影响。方法选择2006年1月～2008年2月在笔者医院产科门诊建卡登记并分娩的孕妇601例,在妊娠第13周、28周及分娩前调查孕妇睡眠打鼾情况、测量孕妇生理生化指标、监测各孕期胎儿生长发育,并追踪至产后记录新生儿资料。根据孕妇打鼾情况,分为孕早期打鼾组、孕中期打鼾组、孕晚期打鼾组和非打鼾组。结果与非打鼾组比较,打鼾组孕妇BMI、腹围在孕早、中、晚期均明显增加,差异有统计学意义(P均<0.05)。收缩压在孕早期无变化,孕中、晚期明显增加,差异有统计学意义(P<0.05);舒张压在孕早、中期无变化(P>0.05)。孕晚期明显增加,差异有统计学意义(P<0.05);打鼾组间孕妇不同孕期BMI、腹围、收缩压及舒张压变化两两比较,差异均无统计学意义(均P>0.05)。孕早、中期打鼾组早产发生率均明显高于非打鼾组,差异有统计学意义(P<0.05),孕晚期打鼾组与非打鼾组比较差异无统计学意义(P>0.05)。打鼾组间早产发生率比较差异无统计学意义(P<0.05)。孕早、中期打鼾组剖宫产发生率均明显高于非打鼾组,差异有统计学意义(P<0.05),孕晚期打鼾组和非打鼾组比较,差异无统计学意义(P>0.05),孕早期和孕中期打鼾组比较无统计学差异,但均高于孕晚期打鼾组,差异有统计学意义(P<0.05)。根据RR分析,孕早期、中期打鼾是早产和剖宫产的危险因素。胎儿生长发育及新生儿相关疾病发生率各组比较无统计学差异(P均>0.05)。结论打鼾使孕妇BMI、腹围增加,血压升高,增加胎儿早产、剖宫产的发生率,应加强打鼾孕妇的围生期保健,早期干预、预防胎儿出生缺陷的发生。
Objective To investigate the effect of snoring during pregnancy on intrauterine growth and development. Methods From January 2006 to February 2008 in our hospital obstetrics and gynecology outpatient card registration and delivery of pregnant women in 601 cases at 13 weeks of pregnancy, 28 weeks before delivery and investigation of pregnant women sleep snoring, physiological and biochemical indicators of pregnant women were measured, monitoring Fetal growth and development during pregnancy, and tracking to postpartum records of newborns. According to the snoring of pregnant women, snoring group was divided into early pregnancy, snoring group in the second trimester, third trimester snoring group and non-snoring group. Results Compared with non-snoring group, the BMI and abdominal circumference of pregnant women in snoring group increased significantly in the early, middle and late stages of pregnancy, the difference was statistically significant (all P <0.05). Systolic blood pressure did not change in the first trimester of pregnancy, pregnancy, late significantly increased, the difference was statistically significant (P <0.05); diastolic blood pressure in the early pregnancy, no change in the middle (P> 0.05). (P <0.05). There was no significant difference in BMI, abdominal circumference, systolic blood pressure and diastolic blood pressure among pregnant women in snoring group (P> 0.05). The incidence of preterm birth in snoring group was significantly higher than that in non snoring group (P <0.05). There was no significant difference between the snoring group and the non-snoring group in the third trimester (P> 0.05). There was no significant difference in the incidence of preterm birth between snoring groups (P <0.05). The incidence of cesarean section in early snoring and middle snoring groups were significantly higher than those in non-snoring group (P <0.05), and there was no significant difference between the snoring group and the non-snoring group in the third trimester (P> 0.05) There was no significant difference between the snoring group in the first trimester and the second trimester, but both were higher than the third trimester snoring group, the difference was statistically significant (P <0.05). According to RR analysis, early pregnancy, mid-term snoring is a risk factor for preterm birth and cesarean section. Fetal growth and neonatal morbidity were no significant difference between groups (P> 0.05). Conclusion Snoring increases pregnant women BMI, abdominal circumference, blood pressure, increased fetal preterm birth, the incidence of cesarean section should strengthen the perinatal care of snoring pregnant women, early intervention, prevention of fetal birth defects.