Pregnancy and fetal outcomes of symptoms of sleep-disordered breathing.
The physiological changes of pregnancy may predispose females to develop sleep-disordered breathing (SDB) or protect against it. Studies evaluating outcomes of SDB symptoms in pregnancy are scarce. The goal of this study was to evaluate the prevalence of SDB symptoms in pregnancy and their relationship with pregnancy and neonatal outcomes. A cross-sectional survey of randomly selected immediate postpartum females was performed using the multivariable apnoea prediction index. Record review, including demographics and medical history, was performed. Main outcome measures included pregnancy and neonatal outcomes. 1,000 subjects were recruited. Mean±sd age was 29.1±6.1 yrs. Factors used in the regression analysis included age, body mass index, diabetes, chronic hypertension, multifetal gestations, smoking and renal disease. Snoring was present in 35.1% of subjects. Symptoms of SDB were associated with a higher likelihood of pregnancy-induced hypertension and pre-eclampsia (adjusted OR 2.3, 95% CI 1.4-4.0), gestational diabetes (adjusted OR 2.1, 95% CI 1.3-3.4) and unplanned Caesarean deliveries (adjusted OR 2.1, 95% CI 1.4-3.2) after multivariable regression analysis. Gasping may have been associated with a higher likelihood of preterm delivery, after adjusting for age and multifetal pregnancies (adjusted OR 1.8, 95% CI 1.1-3.2) but this association appeared to be mediated by pre-eclampsia. Symptoms of SDB are common in pregnancy and associated with a higher likelihood of gestational hypertensive disorders, gestational diabetes and unplanned Caesarean deliveries.
Dept of Medicine, Women and Infants Hospital of Rhode Island, 100 Dudley Street, 3rd Floor, Providence, RI 02905, USA. GBourjeily@wihri.org
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Bourjeily
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Raker
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Chalhoub
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Miller
D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D012044:Regression Analysis; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome