title: Association of adverse perinatal outcomes with screening measures of obstructive sleep apnea.
abstract: OBJECTIVE
  This prospective observational study explored the association of hypertensive disorders of pregnancy and small-for-gestational age with obstructive sleep apnea (OSA) as determined by screening measures for OSA and sleep studies.
  
  
  METHODS
  Two symptom-based screening questionnaires, the Berlin Questionnaire (BQ) and the Epworth Sleepiness Scale (ESS), were administered to enroll 1509 gravidae. Screen-positive subjects were referred for polysomnography. The primary outcome was the occurrence of either gestational hypertension or preeclampsia. Generalized linear models (GLM) were used to estimate the relative risks of associations.
  
  
  RESULTS
  One thousand one hundred and fifty-seven subjects were available for outcomes analysis. Screening positive on the BQ was positively associated with hypertensive disorders in GLM models (adjusted relative risk=1.90, 95% confidence interval 1.52 to 2.37).
  
  
  CONCLUSIONS
  In this large prospective trial, GLM modeling suggests that the BQ but not the ESS demonstrated significant association with measured adverse pregnancy outcomes, and specific items predicted these outcomes better than others. However, causative association of BQ with OSA cannot be assumed.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Antony
authors.affiliation: School of Medicine, University of Texas Health Science Center, Houston, TX, USA.
authors.forename: A
authors.initials: A
authors.lastname: Agrawal
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Arndt
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Murphy
authors.affiliation: Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Alapat
authors.affiliation: Department of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: K K
authors.initials: KK
authors.lastname: Guntupalli
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Aagaard
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis*; D007236:Infant, Small for Gestational Age; D008403:Mass Screening; D008875:Middle Aged; D017286:Polysomnography; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult