Prospective trial on obstructive sleep apnea in pregnancy and fetal heart rate monitoring.
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.
Olivarez
Sofia A
SA
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Ben Taub General Hospital, Houston, TX, USA.
Maheshwari
Bani
B
McCarthy
Meghan
M
Zacharias
Nikolaos
N
van den Veyver
Ignatia
I
Casturi
Lata
L
Sangi-Haghpeykar
Haleh
H
Aagaard-Tillery
Kjersti
K
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