title: Predictors of gastroesophageal reflux symptoms in pregnant women screened for sleep disordered breathing: a secondary analysis.
abstract: BACKGROUND
  Gastroesophageal reflux disease (GERD) is common in pregnancy. The cause is multifactorial, including a decreased or transient lower esophageal sphincter relaxation, increased intra-abdominal pressure, and gastrointestinal motility disturbances.
  
  
  OBJECTIVE
  Evaluate the incidence of GERD in pregnancy and assess predictors and predisposing factors.
  
  
  METHODS
  This is a secondary analysis of a survey of postpartum women regarding symptoms of sleep disordered breathing (SDB) and GERD performed at a large tertiary care center. Patients rated heartburn frequency during pregnancy as either never, occasionally/sometimes, or frequently/always. Pregnancy outcomes and newborn information was collected. Categorical variables were compared by Fisher's exact test and continuous variables were compared by Anova or Kruskal-Wallis test. Multinominal logistic regression was also performed.
  
  
  RESULTS
  Information regarding 1000 mothers and 1025 newborns was reviewed. The majority of mothers were Caucasian (68.8%) with mean age 29 ± 6.1 years. A total of 56.7% had GERD frequently/always; and 25.5% had none. GERD symptoms correlated with pre-pregnancy body mass index (BMI), BMI at delivery, maternal age, smoking and symptoms of SDB. There was no significant correlation between fetal weight and maternal weight gain with GERD symptoms. Symptoms were more frequent in white non-Hispanic women than in other racial groups.
  
  
  CONCLUSIONS
  This study suggests that GERD symptoms correlate with pre-pregnancy BMI and BMI at delivery, but not with the amount of weight gain during pregnancy. Maternal age, smoking, race, and SDB are also associated with GERD. Interestingly, fetal weight/uterine size did not seem predictive of developing GERD in pregnancy.
authors.affiliation: Warren Alpert Medical School of Brown University, Rhode Island Hospital, Gastroenterology, 593, Eddy Street, APC 414, Providence, RI 02903, United States.
authors.forename: Fadlallah
authors.initials: F
authors.lastname: Habr
authors.forename: Christina
authors.initials: C
authors.lastname: Raker
authors.forename: Cui Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Elie
authors.initials: E
authors.lastname: Zouein
authors.forename: Ghada
authors.initials: G
authors.lastname: Bourjeily
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009929:Organ Size; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis*; D014599:Uterus / Q000033:anatomy & histology; D055815:Young Adult