Poor sleep quality is very common among pregnant women. Gestational diabetes mellitus (GDM) has been related to various adverse maternal and neonatal outcomes. The aim of this systematic review was to examine the association between poor sleep quality and gestational diabetes risk. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted in five electronic databases from inception to February 2019. Studies that examined the relationship between sleep quality and glucose in pregnant women were screened for eligibility. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated from aggregate data using a fixed-effect model. Thirteen non-experimental studies (n = 21,194 women) were eligible for inclusion. Poor sleep quality was measured using subjective questionnaires in nine studies and objective methods (actigraphy or polysomnography) in four studies. GDM was typically diagnosed following standard guidelines. Eight studies were included in the meta-analysis for GDM. Overall, self-reported poor sleep quality was a significant risk factor for GDM (pooled OR = 1.43, 95%CI: 1.16,1.77, p = 0.001). Three studies examined the association between objective sleep quality and GDM, but no significant relationship was observed. Subjective poor sleep quality was related to an increased risk for GDM, while objectively measured sleep quality was not. This review was limited by the assessment of sleep quality. Future larger studies are warranted to examine the effects of sleep quality on glucose metabolism in pregnancy. Ideally, these studies should measure sleep quality using both validated questionnaires and objective methods. These will provide further directions for improving sleep during pregnancy and exploring its effects on glucose metabolism.

中文翻译：

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孕妇的睡眠质量和妊娠糖尿病：系统评价和荟萃分析。

睡眠质量差在孕妇中非常普遍。妊娠糖尿病（GDM）与各种不良的母体和新生儿结局有关。该系统评价的目的是检查睡眠质量差与妊娠糖尿病风险之间的关系。遵循系统评价和荟萃分析的首选报告项目指南，从成立到2019年2月，在五个电子数据库中进行了系统搜索。筛选了检查孕妇睡眠质量与血糖之间关系的研究是否合格。使用固定效应模型从汇总数据中计算出具有95％置信区间（CI）的合并优势比（OR）。十三项非实验性研究（n = 21,194名女性）符合纳入条件。在9项研究中使用主观问卷调查了睡眠质量差，在4项研究中使用客观方法（书法或多导睡眠图）测量了睡眠质量。GDM通常是根据标准指南进行诊断的。GDM的荟萃分析包括八项研究。总体而言，自我报告的睡眠质量差是GDM的重要危险因素（合并OR = 1.43，95％CI：1.16,1.77，p = 0.001）。三项研究检查了客观睡眠质量与GDM之间的关联，但未观察到显着相关性。主观的睡眠质量差与GDM风险增加有关，而客观测量的睡眠质量却与之无关。该评价受到睡眠质量评估的限制。将来需要进行更大的研究来检查睡眠质量对孕妇葡萄糖代谢的影响。理想情况下，这些研究应使用经过验证的问卷和客观方法来衡量睡眠质量。这些将为改善怀孕期间的睡眠并探索其对葡萄糖代谢的影响提供进一步的指导。