title: Obstructive sleep apnea in pregnancy: reliability of prevalence and prediction estimates.
abstract: OBJECTIVE
  We sought to ascertain the validity of two screening scales for obstructive sleep apnea (OSA) in pregnancy and to establish the prevalence of OSA in pregnancy.
  
  
  METHODS
  In this prospective observational study, two screening scales were administered. Screen positive subjects were referred for diagnostic polysomnography (PSG); if admitted for antepartum care, screen positive subjects underwent a modified study with a type 3 device (T3D).
  
  
  RESULTS
  A total of 1509 subjects underwent OSA screening; 58 completed diagnostic testing. Neither measure was a reliable diagnostic tool for OSA as determined by T3D or PSG (detection rates of 10.3% and 18.0%, respectively). Among screen positive subjects undergoing PSG or T3D testing, 15.5% ultimately met 'gold standard' OSA diagnostic criteria for an estimated point prevalence of 4.9%.
  
  
  CONCLUSIONS
  In this prospective trial, screening positive on the Berlin questionnaire or Epworth sleepiness scale was poorly predictive of OSA among gravidae and was associated with a high false referral rate.
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; D017286:Polysomnography; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012017:Referral and Consultation; D015203:Reproducibility of Results; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult