title: Sleep disordered breathing in a high-risk cohort prevalence and severity across pregnancy.
abstract: OBJECTIVE
  The objective of this study was to determine the prevalence and incidence of sleep disordered breathing (SDB) in pregnancy among high-risk women.
  
  
  METHODS
  This was a prospective, observational study. We recruited women with a body mass index (BMI) ≥ 30 kg/m(2), chronic hypertension, pregestational diabetes, history of preeclampsia, and/or a twin gestation. Objective assessment of SDB was completed between 6 and 20 weeks and again in the third trimester. SDB was defined as an apnea-hypopnea index (AHI) ≥5, and further grouped into severity categories: mild (5-14.9), moderate (15-29.9) and severe (≥30). Subjects who had a normal AHI at the baseline (AHI < 5), but an abnormal study in the third trimester (AHI ≥5) were classified as having "new-onset" SDB.
  
  
  RESULTS
  A total of 128 women were recruited. In early pregnancy 21, 6 and 3% had mild, moderate, or severe SDB, respectively. These frequencies increased to 35, 7, and 5% in the third trimester (p < 0.001). About 27% (n = 34) experienced a worsening of SDB during pregnancy; 26 were cases of new-onset SDB, while the other 8 had SDB in early pregnancy that worsened in severity. The incidence of new-onset SDB was 20%. The majority of these new-onset cases were mild.
  
  
  CONCLUSIONS
  SDB in early pregnancy is common in high-risk women and new-onset SDB occurs in 20% of these women.
authors: Department of Obstetrics and Gynecology, University of Pittsburgh, Magee Womens Hospital, Chicago, Illinois.
authors: Francesca L
authors: FL
authors: Facco
authors: Department of Obstetrics and Gynecology, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Evanston, Illinois.
authors: David W
authors: DW
authors: Ouyang
authors: Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors: Phyllis C
authors: PC
authors: Zee
authors: Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors: William A
authors: WA
authors: Grobman
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D017286:Polysomnography; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011264:Pregnancy Trimesters; D059285:Pregnancy, Twin; D015995:Prevalence; D011446:Prospective Studies; D017584:Reproductive History; D012307:Risk Factors; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology*