产前阻塞性睡眠呼吸暂停筛查及其与产后呼吸抑制的关联：一项回顾性队列研究（2020-2025）
Antepartum obstructive sleep apnea screening and its association with postpartum respiratory depression: a retrospective cohort study (2020-2025).
文献信息
| PMID | 42822063 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Pinyi Zhang |
| 作者单位 | Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; Department of Anesthesiology, Harbin Medical University Cancer Hospital, Harbin, China. Electronic address: py_zhang0609@outlook.com. |
| 期刊 | International journal of obstetric anesthesia |
| SCI 分区 | Q2 |
| IF | 3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 围产期人群未常规筛查阻塞性睡眠呼吸暂停，其与产后呼吸抑制的关联仍不明确。我们评估了产前阻塞性睡眠呼吸暂停筛查阳性及其与产后呼吸结局的关联。
方法： 我们开展了一项单中心回顾性队列研究，纳入2020年7月至2025年6月期间接受常规产前阻塞性睡眠呼吸暂停STOP筛查（大声打鼾、日间疲倦、目击呼吸暂停、高血压）的产妇。纳入至少有一项STOP应答的分娩记录。STOP筛查阳性定义为≥2项标准。产后呼吸结局包括呼吸过缓、氧饱和度下降和纳洛酮给药。采用logistic回归评估STOP筛查阳性、各STOP组分及自报阻塞性睡眠呼吸暂停与产后呼吸结局的关联。
结果： 在19,250例分娩记录中，608例（3.2%）筛查阳性，182例（1.0%）自报阻塞性睡眠呼吸暂停。呼吸过缓发生率为2.8%（532/19,237），氧饱和度下降发生率为2.4%（356/14,723）。STOP筛查阳性与氧饱和度下降相关（校正OR 1.86，95% CI 1.21-2.88；P = 0.005），但与呼吸过缓无关。子痫前期或高血压诊断与呼吸过缓（OR 1.64，95% CI 1.14-2.35）和氧饱和度下降（OR 2.88，95% CI 2.06-4.03）相关。自报阻塞性睡眠呼吸暂停与呼吸过缓（OR 2.01，95% CI 1.06-3.84）和氧饱和度下降（OR 2.72，95% CI 1.46-5.08）相关。打鼾、疲倦和目击呼吸暂停与氧饱和度下降相关，但与呼吸过缓无关。
结论： 产前STOP筛查阳性与产后氧饱和度下降相关，但与呼吸过缓无关。子痫前期或高血压诊断可能是产后呼吸抑制的重要筛查问题。
英文摘要
BACKGROUND: Obstructive sleep apnea is not routinely screened for in the peripartum population, and its association with postpartum respiratory depression remains unclear. We evaluated positive antepartum obstructive sleep apnea screening and its association with postpartum respiratory outcomes.
METHODS: We conducted a single-center retrospective cohort study of parturients undergoing routine antepartum obstructive sleep apnea STOP screening (loud snoring, daytime tiredness, observed apnea, high blood pressure) from July 2020 to June 2025. Delivery encounters with at least one STOP response were included. Positive STOP screening was defined as ≥2 criteria. Postpartum respiratory outcomes included bradypnea, oxygen desaturation, and naloxone administration. Associations of positive STOP screening, individual STOP components, and self-reported obstructive sleep apnea with postpartum respiratory outcomes were evaluated using logistic regression.
RESULTS: Among 19,250 delivery encounters, 608 (3.2%) screened positive and 182 (1.0%) reported obstructive sleep apnea. Bradypnea occurred in 2.8% (532/19,237) and oxygen desaturation in 2.4% (356/14,723). Positive STOP screening was associated with desaturation (adjusted OR 1.86, 95% CI 1.21-2.88; P = 0.005), but not bradypnea. Preeclampsia or a hypertensive diagnosis was associated with bradypnea (OR 1.64, 95% CI 1.14-2.35) and desaturation (OR 2.88, 95% CI 2.06-4.03). Self-reported obstructive sleep apnea was associated with bradypnea (OR 2.01, 95% CI 1.06-3.84) and desaturation (OR 2.72, 95% CI 1.46-5.08). Snoring, tiredness, and observed apnea were associated with desaturation but not bradypnea.
CONCLUSION: Positive antepartum STOP screening was associated with postpartum desaturation but not bradypnea. Preeclampsia or a hypertensive diagnosis may be an important screening question for postpartum respiratory depression.