Abstrakt

This overview shows how the physical and, in particular, hormonal changes during pregnancy affect breathing and sleep and how and when breathing and sleep develop in the fetus. Pregnancy has a significant influence on respiratory regulation and respiratory mechanics as well as on sleep regulation. Due to its increased size, the uterus restricts the maximum voluntary ventilation; the pregnancy hormone progesterone, on the other hand, causes compensatory bronchodilatation and marked hyperventilation with arterial PCO2 values of the pregnant women below 30 mmHg. Sleep quality decreases during pregnancy, especially due to increasing hormone levels of progesterone, a general metabolism, nocturia, fetal movements, and the promotion of sleep-related breathing disorders. In the embryo, the lung develops as early as the 4th week and matures through a pseudoglandular, canalicular, sacular to the alveolar stage. From pregnancy week 29 – 30 type 2 alveocytes begin to produce surfactant. From the middle of the second trimester fetal respiratory movements are detectable. They cause the essential stimulus for adequate lung growth, are dependent on the resting/ activity rhythm of the fetus and respond to increased carbon dioxide partial pressure, while they are inhibited by hypoxia. The fetal internal clock develops in the last trimester, and is controlled by “zeitgeber” of the mother, e.g., by the melatonin level. In the last 10 weeks of pregnancy, phases of quiet (NREM) and active (REM) sleep can be differentiated. Pregnancy and intrauterine development are accompanied by considerable changes in breathing and sleep in mother and child, which can be the starting points of pathophysiological developments.

Autoreninformation

Autoren

• T. Schäfer^{1, 2}
• M.E. Schläfke^{1, 2}

Abteilungen

• ¹ Ruhr-Universität Bochum, Medizinische Fakultät, Bochum,
• ² HELIOS Klinik Hagen-Ambrock, Klinische Physiologie, Hagen

Adresse

Prof. Dr. med. Thorsten Schäfer
Ruhr-Universität Bochum
Medizinische Fakultät
Universitätsstraße 150
44780 Bochum
Email: [email protected]

Citation