Sleep disordered breathing (SDB) is a common obesity-related co-morbidity with strong associations to cardiometabolic disease. The risk of SDB is increased during pregnancy, particularly amongst obese pregnant women. Accumulating evidence suggests that an association exists between maternal SDB and the development of adverse pregnancy outcomes, particularly gestational diabetes and hypertensive disorders of pregnancy. Intermittent hypoxia, a central characteristic of SDB, has been shown in animal and clinical studies to dysregulate several biological pathways. This includes the promotion of oxidative stress, increased inflammation, activation of the hypothalamic-pituitary-adrenal axis, increased sympathetic activity and impaired glucose and insulin metabolism. This review considers how, during pregnancy, these pathophysiological processes are plausible mechanisms through which SDB may contribute to an increased risk of adverse outcomes, for the mother and perhaps also the offspring. However, a lack of robust evidence specific to the pregnant population, including limited evaluation of the placental function in affected pregnancies, limits our ability draw definite conclusions on mechanisms contributing to adverse pregnancy outcomes and, indeed, the strength of association between SDB and certain pregnancy complications.

中文翻译：

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妊娠期睡眠呼吸障碍：不良妊娠结局的病理生理学综述。

睡眠呼吸障碍 (SDB) 是一种常见的肥胖相关并发症，与心脏代谢疾病密切相关。SDB 的风险在怀孕期间增加，特别是在肥胖孕妇中。越来越多的证据表明，母亲 SDB 与不良妊娠结局的发生之间存在关联，尤其是妊娠糖尿病和妊娠高血压疾病。间歇性缺氧是 SDB 的一个核心特征，已在动物和临床研究中显示出几种生物学途径的失调。这包括氧化应激的促进、炎症增加、下丘脑-垂体-肾上腺轴的激活、交感神经活动增加以及葡萄糖和胰岛素代谢受损。本综述考虑了在怀孕期间如何，这些病理生理过程是似是而非的机制，通过这些机制，SDB 可能会导致母亲甚至后代出现不良后果的风险增加。然而，缺乏针对妊娠人群的有力证据，包括对受影响妊娠中胎盘功能的有限评估，限制了我们对导致不良妊娠结果的机制得出明确结论的能力，事实上，SDB 与某些妊娠之间的关联强度并发症。