妊娠初期の睡眠不足は、妊娠糖尿病のその後のリスクを高めます

目的：妊娠中の睡眠の質の低さと妊娠糖尿病（GDM）のリスクとの関係を調べる。 方法：妊娠前に明白な糖尿病を伴わずに、舌の母子保健コホート（TMCHC）の合計4066人のシングルトン妊婦が分析されました。妊娠初期の睡眠の質と期間は、16週間の妊娠前の最初の出生前ケア訪問で登録された女性によって自己報告されました。妊娠糖尿病（GDM）は、24〜28週間の妊娠で75-G、2時間の経口グルコース耐性試験で評価されました。現時点では、自己報告された睡眠の質と妊娠中の期間に関する情報も収集されました。オッズ比（OR）および95％CIは、多変数ロジスティック回帰モデルによって計算され、潜在的な交絡因子を調整して、睡眠の質の低下と睡眠の質と期間の間の相互作用をGDMの開発に合わせて推定しました。層別分析は、年齢、パリティ、糖尿病の家族歴、昼寝に応じて実施されました。 結果：合計335人（8.2％）の参加者がGDMと診断されました。睡眠の質は、妊娠初期の259人（6.4％）の女性、妊娠中期に248人（6.1％）で報告されました。GDMのリスクは、妊娠初期の睡眠の質が低い女性で増加しました（OR 1.77、95％CI 1.20-2.61）。妊娠中の睡眠の質の低下とGDMのリスクとの間には、関連性は見られませんでした。GDMのリスクは、妊娠初期の睡眠不良と夜間の睡眠期間が長い女性で最も高かった（OR 2.27、95％CI 1.20-4.29）。層別分析では、妊娠初期の睡眠の質の低さとGDMのリスクとの関連は、30歳以上（OR 2.35、95％CI 1.35-4.09）と糖尿病の家族歴のある女性（OR 4.02、95）の間でより強いことがわかりました。％CI 1.54-10.48）。 結論：妊娠初期の睡眠の質の低下は、GDMのリスクの増加と関連していた。妊娠初期の睡眠問題のスクリーニングと治療は、GDMのリスクを減らす可能性があります。

OBJECTIVES: To examine the relationship between poor sleep quality during pregnancy and the risk of gestational diabetes mellitus (GDM). METHODS: A total of 4066 singleton pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) without overt diabetes before pregnancy were analyzed. Sleep quality and duration during early pregnancy were self-reported by enrolled women at their first antenatal care visit before 16 weeks of gestation. Gestational diabetes mellitus (GDM) was assessed with a 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation. Information about self-reported sleep quality and duration in mid-pregnancy were also collected at this time. Odds ratios (OR) and 95% CIs were calculated by multivariable logistic regression models, and adjusted for potential confounders to estimate the effect of poor sleep quality and the interaction between sleep quality and duration on the development of GDM. Stratified analyses were performed according to age, parity, family history of diabetes and napping. RESULTS: A total of 335 (8.2%) participants were diagnosed with GDM. Poor sleep quality was reported in 259 (6.4%) women during early pregnancy and 248 (6.1%) in mid-pregnancy. The risk of GDM was increased in women with poor sleep quality during early pregnancy (OR 1.77, 95% CI 1.20-2.61). No association was found between poor sleep quality during mid-pregnancy and the risk of GDM. The risk of GDM was highest in women with poor sleep and longer nighttime sleep duration during early pregnancy (OR 2.27, 95% CI 1.20-4.29) when compared with those who reported good sleep and 7.0-8.5 h of sleep duration per night. Stratified analysis found that the association between poor sleep quality in early pregnancy and the risk of GDM was stronger among women aged ≥30 years (OR 2.35, 95% CI 1.35-4.09) and those with a family history of diabetes (OR 4.02, 95% CI 1.54-10.48). CONCLUSIONS: Poor sleep quality during early pregnancy was associated with an increased risk of GDM. Screening for and treating sleep problems in early pregnancy could potentially reduce the risk of GDM.