Objective: To evaluate the clinical utility value of questionnaires of Berlin, STOP, STOP-Bang (SBQ), Epworth Sleepiness Scale (ESS) in screening obstructive sleep apnea syndrome (OSAS) in pregnant women of different trimesters. Methods: Consecutive pregnant women at high risk for OSAS were enrolled from January, 2021 to April, 2022 at the obstetric clinic of Peking University People's Hospital. They completed questionnaires of Berlin, STOP, SBQ, ESS and also underwent an overnight polysomnography (PSG). To evaluate the accuracy of questionnaires of Berlin, STOP, SBQ, ESS, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics (ROC) curve of these questionnaires in pregnancy across trimesters (Pregnancy 1-15 weeks was the first stage, pregnancy 16-27 weeks was the second stage, and pregnancy 28-40 weeks was the third stage) were calculated. Results: A total of 100 pregnant women [(34.5±4.3) years old (26-46 years old)] were included in this study, including 20, 35 and 45 pregnant women in the first, second and third trimester of pregnancy, respectively. Based on PSG results, 45 (45%) of 100 pregnant women were diagnosed with OSAS. The overall predictive values of the four questionnaires were not good, area under[AUC(95%CI)] the ROC curve ESS, Berlin questionnaire STOP and SBQ were 0.54(0.43, 0.66), 0.59 (0.47, 0.70), 0.62(0.51, 0.73) and 0.61 (0.49, 0.72), respectively, sensitivity was 35.6%, 65.9%, 48.9%, 28.9%, specificity was 71.7%, 52.5%, 73.6%, 92.5%. When categorized according to trimesters, the predicted values of the four questionnaires increased in the first trimester, the AUC (95%CI) of STOP questionnaire was 0.81 (0.61, 1.00), sensitivity was 75.0%, specificity was 87.5%. Conclusion: The overall predictive power of the four screening questionnaires is limited in pregnant women. But predictive value of STOP questionnaire is acceptable in the first trimester.
目的： 评估柏林问卷、STOP问卷、STOP-Bang问卷（SBQ）和Epworth嗜睡量表（ESS）在不同妊娠阶段筛查阻塞性睡眠呼吸暂停综合征（OSAS）中的应用价值。 方法： 前瞻性选取2021年1月至2022年4月于北京大学人民医院产科门诊连续就诊的疑诊OSAS妊娠妇女作为研究对象，对其进行柏林问卷、STOP问卷、SBQ和ESS评分；进行整夜多导睡眠监测（PSG），呼吸暂停低通气指数（AHI）≥5次/h，诊断为OSAS。计算不同妊娠阶段（妊娠1~15周为第1阶段，妊娠16~27周为第2阶段，妊娠28~40周为第3阶段）柏林问卷、STOP问卷、SBQ和ESS筛查OSAS的灵敏度、特异度，并利用受试者工作特征（ROC）曲线评价4种量表在不同妊娠阶段筛查OSAS的准确度。 结果： 共有100名妊娠妇女纳入本研究，年龄为（34.5±4.3）岁（26~46岁）。妊娠1、2、3阶段分别纳入20、35、45名。根据PSG结果，100名孕妇中45例诊断为OSAS。4种筛查量表的总体预测效果均欠佳，ESS、柏林问卷、STOP问卷和SBQ ROC曲线下面积［AUC（95%CI）］分别为0.54（0.43，0.66）、0.59（0.47，0.70）、0.62（0.51，0.73）和0.61（0.49，0.72），灵敏度分别为35.6%，65.9%，48.9%，28.9%，特异度为71.7%，52.5%，73.6%，92.5%。其中在妊娠1阶段的STOP问卷的AUC最大，95%CI为0.81（0.61，1.00），灵敏度为75.0%，特异度为87.5%。 结论： 4种筛查问卷在妊娠人群中预测OSAS能力有限。但在妊娠第1阶段，STOP问卷具有一定的预测价值。.