title: Prospective trial on obstructive sleep apnea in pregnancy and fetal heart rate monitoring.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) involves episodic nocturnal apneas. Using polysomnography, we examined the predictive capacity of screening questionnaires (Berlin) in pregnancy. Incorporating simultaneous fetal heart rate monitoring (FHM), we examined the association of maternal apnea with FHM abnormalities.
  
  
  METHODS
  We enrolled 100 pregnant women at 26-39 weeks of gestation with OSA screening and baseline data ascertainment who underwent polysomnography and FHM for > or =3 hours. The relationship between maternal characteristics, OSA, and FHM was explored with multivariate analyses that were controlled for potential confounders.
  
  
  RESULTS
  When compared with polysomnography, sensitivity and specificity by Berlin screening was 35% and 63.8%, respectively; the snoring component of the Berlin correlated better with oxygen desaturation <95% (P = .003). Body mass index was a significant confounder (r(s) = 0.44; P < .0001). No association was observed between FHM abnormalities and OSA parameters.
  
  
  CONCLUSIONS
  In pregnancy, the Berlin questionnaire poorly predicts OSA. It is unclear whether fetal compromise during maternal apnea is a mechanism in OSA that is related to pregnancy outcome.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Ben Taub General Hospital, Houston, TX, USA.
authors.forename: Sofia A
authors.initials: SA
authors.lastname: Olivarez
authors.forename: Bani
authors.initials: B
authors.lastname: Maheshwari
authors.forename: Meghan
authors.initials: M
authors.lastname: McCarthy
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Zacharias
authors.forename: Ignatia
authors.initials: I
authors.lastname: van den Veyver
authors.forename: Lata
authors.initials: L
authors.lastname: Casturi
authors.forename: Haleh
authors.initials: H
authors.lastname: Sangi-Haghpeykar
authors.forename: Kjersti
authors.initials: K
authors.lastname: Aagaard-Tillery
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015148:Cardiotocography; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D015999:Multivariate Analysis; D018579:Patient Selection; D017286:Polysomnography; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires