Study On The Effect Of Metabolism Associated Factors And Proinflammatory Cytokines On Low Sleep Quality In Woman In Late Pregnancy

Objective: The present study aimed to investigate the relationship among plasma cortiotropin releasing hormone(CRH),Leptin(LP),interleukin-6(IL-6),tumor necrosis factor-hormone(TNF-?)levels and low sleep quality in pregnant women during pregnancy for providing the theoretical basis and clinical guidance for the prediction,prevention and clinical intervention of late trimester of pregnancy.Methods: Forty-four pregnant women in the Affiliated Hospital of Inner Mongolia Medical University were selected as the research objects.The Pittsburgh Sleep Quality Index(PSQI)and Patient Health Questionnaire-9(PHQ-9)were collected at three time points of pregnancy: first trimester of pregnancy,second trimester of pregnancy and late trimester of pregnancy(first trimester of pregnancy:11-13 weeks,second trimester of pregnancy: 24-28 weeks,late trimester of pregnancy: 37-42 weeks),to evaluate sleep quality and depression.At the same time,the peripheral blood was collected at three time points of first trimester of pregnancy,second trimester of pregnancy and late trimester of pregnancy.The levels of CRH,LP,TNF-? and IL-6 were measured by enzyme-linked immunosorbent assay.The PSQI scores,sleep related indexes,PHQ-9 scores,the levels of CRH,LP,IL-6 and TNF-? among the three time points of participants were calculated using ANOVA;The relationship between PSQI scores,sleep related indexes and PHQ-9 scores,the levels of CRH,LP,TNF-? and IL-6 were analyzed using Pearson correlation.Results:(1)Comparison of the PSQI global scores of all subjects in first trimester of pregnancy,second trimester of pregnancy and the late trimester of pregnancy and each sub-item:(1)The differences of the PSQI global scores among the three time points were significant(P<0.05),and the PSQI global scores showed an increasing;(2)The difference of the PSQI C1 scores(subjective sleep quality)among the three time points were significant(P<0.05),showing an increasing;(3)The difference of the PSQI C7 scores(daytime dysfunction)among the three periods were significant(P<0.05),showing an increasing;(4)Further pairwise comparison were performed in three periods and PSQI C1,PSQI C7,and the PSQI global scores were found to be statistically significant in first trimester of pregnancy and second trimester of pregnancy,first trimester of pregnancy and late trimester of pregnancy,second trimester of pregnancy and late trimester of pregnancy(P<0.05).(2)In all subjects,CRH levels,IL-6levels,LP levels and TNF-? levels in first trimester of pregnancy,second trimester of pregnancy and late trimester of pregnancy were compared,and the results showed that:(1)The differences of IL-6 levels and CRH levels in the three periods were significant(P<0.05),and the levels of IL-6 and CRH showed an increasing;(2)Further pairwise comparison were performed in three periods,and the levels of IL-6 and CRH were found to be statisticallysignificant in first trimester of pregnancy and second trimester of pregnancy,first trimester of pregnancy and late trimester of pregnancy,second trimester of pregnancy and late trimester of pregnancy(P<0.05).(3)The correlation between CRH levels,IL-6 levels,LP levels,TNF-?levels and sub-item of PSQI scores at three different time points in first trimester of pregnancy,second trimester of pregnancy and late trimester of pregnancy were analyzed,(1)first trimester of pregnancy: CRH levels were positively correlated with PSQI C1 scores(P<0.05).IL-6 levels were positively correlated with PSQI CI scores,PSQI C2 scores and PSQI C7scores(P<0.05);(2)In the second trimester of pregnancy,both CRH and IL-6 levels were positively correlated with PSQI C1 scores(P<0.05).TNF-? levels were positively correlated with PSQI C1 scores(P<0.05);(3)In the third trimester of pregnancy,both CRH and IL-6levels were positively correlated with PSQI C1 scores(P<0.05).TNF-? levels were positively correlated with PSQI C1 scores(P<0.05).(4)The correlation between the PSQI global scores and the levels of CRH,LP,IL-6 and the PHQ-9 scores at the time points in first trimester of pregnancy,second trimester of pregnancy and late trimester of pregnancy of all subjects are analyzed:(1)First trimester of pregnancy:The PSQI global scores were positively correlated with the levels of CRH and IL-6(P<0.05);(2)In the second trimester,the PSQI global scores were positively correlated with the levels of CRH,IL-6,LP,and PHQ-9 scores(P<0.05).(5)Pearson correlation was used to analyze the correlation between the third trimester of pregnancy had separate relationships with first trimester of pregnancy and second trimester of pregnancy of levels of CRH,LP,IL-6,TNF-?,and PHQ-9 scores,the results showed that: the PSQI global scores in the third trimester of pregnancy were positively correlated with the first trimester of pregnancy CRH,IL-6 levels and PHQ-9 scores(P<0.05);The PSQI global scores in the third trimester were positively correlated with the levels of CRH,IL-6 and PHQ-9 scores in the second trimester,and negatively correlated with LP levels(P<0.05).(6)Multiple linear regression analysis showed that CRH plasma levels,PHQ-9scores and the PSQI global scores in the first trimester had an impact on sleep quality in the third trimester of pregnancy,and first trimester of pregnancy the PSQI global scores had a greater impact on sleep quality in the third trimeste.The levels of IL-6,PHQ-9 scores and the PSQI global scores in the second trimester affect sleep quality in the third trimester,and IL-6levels in the second trimester had a greater impact on sleep quality in the third trimester.Conclusion: The poor sleep quality of pregnant women during the whole pregnancy is related to the high levels of CRH and IL-6.The high levels of CRH and IL-6 in pregnant women lead to the daytime dysfunction and sleep quality decline more serious.The high levels of IL-6 in late trimester of pregnancy can aggravate the low sleep quality.First trimester of pregnancy the PSQI global scores can predict the quality of poor sleep in late trimester of pregnancy.IL-6 levels and the PSQI global scores in second trimester of pregnancy can predict the quality of poor sleep in late pregnancy.This study provides new strategies and ideas for the prediction,prevention and clinical intervention of poor sleep quality in late trimester of pregnancy,and has important clinical reference.