Maternal Sleep-Disordered Breathing in Pregnancy and Increased Nocturnal Glucose Levels in Women with Gestational Diabetes Mellitus

Newbold, R.; Benedetti, Andrea; Kimoff, R. John; Meltzer, S. J.; Garfield, Natasha; Dasgupta, Kaberi; Gagnon, Robert; Lavigne, L.; Olha, A.; Rey, Évelyne; Pamidi, Sushmita

doi:10.1016/j.chest.2020.07.014

Cited by 14 publications

(13 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, seven articles included were published in the last five years. Among these articles, there were three randomized controlled trials (RCT) [26][27][28].…”

Section: Resultsmentioning

confidence: 99%

A Review of the Associations Between Obstructive Sleep Apnea and Gestational Diabetes Mellitus and Possible Mechanisms of Disease

et al. 2022

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA) usually leads to the occurrence of diabetes. Gestational diabetes mellitus (GDM) is a common gestational complication associated with adverse maternal and fetal outcomes. Increasing studies suggest that women with OSA during pregnancy may be at a significantly greater risk of developing GDM. It is crucial to explore the association between OSA and GDM and the mechanisms underlying this association. In this review, we presented a comprehensive literature review of the following: the association between OSA and GDM, the possible mechanisms of this association, and the effects of continuous positive airway pressure (CPAP) on OSA with GDM. The results showed that most authors suggested that there was an association between OSA and GDM. The intermittent hypoxemia (IH) and reduction of slow-wave sleep (SWS) may be the key to this association. IH induces the products of oxidative stress and inflammation as well as dysregulation of the hypothalamic–pituitary–adrenal, which lead to diabetes. In addition, SWS reduction in OSA enhances the inflammation by increasing the inflammatory cytokines, increases the sympathetic activation, and causes changes in leptin level, which result in the development of GDM. Additionally, whether CPAP is beneficial to GDM remains still unclear.

show abstract

“…In addition, seven articles included were published in the last five years. Among these articles, there were three randomized controlled trials (RCT) [26][27][28].…”

Section: Resultsmentioning

confidence: 99%

A Review of the Associations Between Obstructive Sleep Apnea and Gestational Diabetes Mellitus and Possible Mechanisms of Disease

et al. 2022

View full text Add to dashboard Cite

show abstract

“…High glucose status in patients with gestational diabetes can alter the intestinal environment and cause changes in intestinal pH [26][27][28]. Probiotics such as Bifidobacterium and Lactobacillus are sensitive to changes in the internal environment, which can be significantly reduced once the intestinal environment changes [29][30][31]. While Bifidobacterium can regulate intestinal dysfunction, Lactobacillus can maintain intestinal health and regulate immune function, Escherichia coli is parasitic in the large intestine, and invasion of the body can cause infection.…”

Section: Discussionmentioning

confidence: 99%

Effect of Evidence-Based Diet Nursing on Intestinal Flora and Maternal and Infant Prognosis in Patients with Gestational Diabetes

Jiang

Qiu

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Background. Gestational diabetes mellitus (GDM) refers to the diabetes first discovered or occurring during pregnancy. The incidence of gestational diabetes in China is about 1%–5%, with an increasing trend in recent years. Objective. To observe the effect of evidence-based diet nursing on intestinal flora and maternal and infant prognosis in patients with gestational diabetes. Methods. One hundred and thirty patients with GDM admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups according to the intervention method, with 65 cases in each group. The control group was given routine nursing plus diet nursing, while the observation group was given evidence-based nursing plus diet nursing. The changes of blood glucose index and intestinal flora before and after intervention in the two groups were detected, and the compliance behavior, pregnancy outcome, and perinatal outcome in the two groups were statistically analyzed. Results. After the intervention, the fasting blood glucose, 2 h postprandial blood glucose, and HbA1c in the two groups gradually decreased ( P < 0.05 ). Further comparison between the groups showed that the fasting blood glucose, 2 h postprandial blood glucose, and HbA1c in the observation group were lower than those in the control group ( P < 0.05 ). After intervention, the ratios of Bifidobacterium, Lactobacillus, and Bifidobacterium to E. coli in the two groups gradually increased ( P < 0.05 ). Furthermore, comparison between the groups showed that the ratios of Bifidobacterium, Lactobacillus, and Bifidobacterium to E. coli in the observation group were higher than those in the control group ( P < 0.05 ). The blood glucose rate, regular prenatal examination rate, and diet control rate of the observation group were 100.00%, 100.00%, and 95.38%, respectively, which were higher than 89.23%, 92.31%, and 84.62% of the control group, and the difference was significant ( P < 0.05 ). The pregnancy infection rate and cesarean section rate in the observation group were 0.00% and 33.85%, respectively, which were lower than 6.15% and 60.00% in the control group, and the difference was significant ( P < 0.05 ).The premature delivery rate and polyhydramnios rate in the observation group were 3.08% and 1.54%, respectively, which were not significantly different from 6.15% to 7.69% in the control group ( P > 0.05 ). The rates of macrosomia, neonatal hypoglycemia, and neonatal hyperbilirubinemia in the observation group were 1.54%, 3.08%, and 9.23%, respectively, which were lower than those in the control group (10.77%, 13.85%, and 23.08%), and the differences were significant ( P < 0.05 ). The fetal malformation rate and neonatal asphyxia rate in the observation group were 0.00% and 1.54%, respectively, which were not significantly different from 1.54% to 7.69% in the control group ( P > 0.05 ). Conclusion. The application of evidence-based care combined with dietary care in GDM patients can improve intestinal flora, control blood glucose, improve patient compliance behavior, and improve maternal and infant outcomes.

show abstract

“…GDM risk was also significantly higher among women with higher overall apnea–hypopnea index, higher apnea–hypopnea index in REM, and higher oxygen desaturation index, as measured by polysomnography as well as symptom scores [ 186 ]. Furthermore, severity of sleep disordered breathing in women with GDM correlates with higher nocturnal and morning glucose levels, after adjusting for BMI and medications [ 187 ], suggesting that sleep disordered breathing may worsen blood glucose control in women with GDM.…”

Section: Methodsmentioning

confidence: 99%

Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review

Beroukhim

Esencan

Seifer

2022

Reprod Biol Endocrinol

View full text Add to dashboard Cite

Sleep is vital to human bodily function. Growing evidence indicates that sleep deprivation, disruption, dysrhythmia, and disorders are associated with impaired reproductive function and poor clinical outcomes in women. These associations are largely mediated by molecular-genetic and hormonal pathways, which are crucial for the complex and time sensitive processes of hormone synthesis/secretion, folliculogenesis, ovulation, fertilization, implantation, and menstruation. Pathologic sleep patterns are closely linked to menstrual irregularity, polycystic ovarian syndrome, premature ovarian insufficiency, sub/infertility, and early pregnancy loss. Measures of success with assisted reproductive technology are also lower among women who engage in shift work, or experience sleep disruption or short sleep duration. Extremes of sleep duration, poor sleep quality, sleep disordered breathing, and shift work are also associated with several harmful conditions in pregnancy, including gestational diabetes and hypertensive disorders. While accumulating evidence implicates pathologic sleep patterns in impaired reproductive function and poor reproductive outcomes, additional research is needed to determine causality and propose therapeutic interventions.

show abstract

Maternal Sleep-Disordered Breathing in Pregnancy and Increased Nocturnal Glucose Levels in Women with Gestational Diabetes Mellitus

Cited by 14 publications

References 56 publications

A Review of the Associations Between Obstructive Sleep Apnea and Gestational Diabetes Mellitus and Possible Mechanisms of Disease

A Review of the Associations Between Obstructive Sleep Apnea and Gestational Diabetes Mellitus and Possible Mechanisms of Disease

Effect of Evidence-Based Diet Nursing on Intestinal Flora and Maternal and Infant Prognosis in Patients with Gestational Diabetes

Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review

Contact Info

Product

Resources

About

Maternal Sleep-Disordered Breathing in Pregnancy and Increased Nocturnal Glucose Levels in Women with Gestational Diabetes Mellitus

Cited by 14 publications

References 56 publications

A Review of the Associations Between Obstructive Sleep Apnea and Gestational Diabetes Mellitus and Possible Mechanisms of Disease

A Review of the Associations Between Obstructive Sleep Apnea and Gestational Diabetes Mellitus and Possible Mechanisms of Disease

Effect of Evidence-Based Diet Nursing on Intestinal Flora and Maternal and Infant Prognosis in Patients with Gestational Diabetes

Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review

Contact Info

Product

Resources

About

Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review