title: Association between maternal symptoms of sleep disordered breathing and fetal telomere length.
abstract: OBJECTIVE
  Our investigation aims to assess the impact of symptoms of maternal sleep-disordered breathing, specifically sleep apnea risk and daytime sleepiness, on fetal leukocyte telomere length.
  
  
  METHODS
  Pregnant women were recruited upon hospital delivery admission.
  
  
  METHODS
  Sleep exposure outcomes were measured using the Berlin Questionnaire to quantify sleep apnea and the Epworth Sleepiness Scale to measure daytime sleepiness. Participants were classified as "High Risk" or "Low Risk" for sleep apnea based on responses to the Berlin, while "Normal" or "Abnormal" daytime sleepiness was determined based on responses to the Epworth.
  
  
  METHODS
  Neonatal umbilical cord blood samples (N = 67) were collected and genomic DNA was isolated from cord blood leukocytes using Quantitative PCR. A ratio of relative telomere length was derived by telomere repeat copy number and single copy gene copy number (T/S ratio) and used to compare telomere lengths. Bootstrap and ANOVA statistical procedures were employed.
  
  
  RESULTS
  On the Berlin, 68.7% of participants were classified as Low Risk while 31.3% were classified as High Risk for sleep apnea. According to the Epworth scale, 80.6% were determined to have Normal daytime sleepiness, and 19.4% were found to have Abnormal daytime sleepiness. The T/S ratio among pregnant women at High Risk for sleep apnea was significantly shorter than for those at Low Risk (P value < 0.05), and the T/S ratio among habitual snorers was significantly shorter than among non-habitual snorers (P value < 0.05). Although those with Normal Sleepiness had a longer T/S ratio than those with Abnormal Sleepiness, the difference was not statistically significant.
  
  
  CONCLUSIONS
  Our results provide the first evidence demonstrating shortened telomere length among fetuses exposed to maternal symptoms of sleep disordered breathing during pregnancy, and suggest sleep disordered breathing as a possible mechanism of accelerated chromosomal aging.
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.|Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL.
authors.forename: Hamisu M
authors.initials: HM
authors.lastname: Salihu
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.|Lawton and Rhea Chiles Center for Healthy Mothers and Babies, University of South Florida, Tampa, FL.
authors.forename: Lindsey
authors.initials: L
authors.lastname: King
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.
authors.forename: Priyanshi
authors.initials: P
authors.lastname: Patel
authors.affiliation: Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.
authors.forename: Arnut
authors.initials: A
authors.lastname: Paothong
authors.affiliation: Department of Global Health, College of Public Health, University of South Florida, Tampa, FL.
authors.forename: Anupam
authors.initials: A
authors.lastname: Pradhan
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL.
authors.forename: Judette
authors.initials: J
authors.lastname: Louis
authors.affiliation: Department of Global Health, College of Public Health, University of South Florida, Tampa, FL.|Emergency Department, James A Haley VA Hospital, Tampa, FL.
authors.forename: Eknath
authors.initials: E
authors.lastname: Naik
authors.affiliation: University of South Florida Health, Tampa, FL.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Marty
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL.
authors.forename: Valerie
authors.initials: V
authors.lastname: Whiteman
mesh_terms: D000293:Adolescent; D000328:Adult; D001604:Berlin; D016922:Cellular Senescence / Q000235:genetics*; D004247:DNA / Q000235:genetics / Q000302:isolation & purification / Q000378:metabolism; D005260:Female; D005312:Fetal Blood / Q000166:cytology / Q000378:metabolism; D005333:Fetus / Q000166:cytology / Q000378:metabolism*; D006801:Humans; D007962:Leukocytes / Q000166:cytology / Q000378:metabolism; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011297:Prenatal Exposure Delayed Effects / Q000235:genetics* / Q000473:pathology; D012891:Sleep Apnea Syndromes / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000503:physiopathology; D011795:Surveys and Questionnaires; D020080:Tandem Repeat Sequences / Q000235:genetics; D016615:Telomere / Q000235:genetics* / Q000502:physiology; D055815:Young Adult
chemical_list: D004247:DNA
keywords: bootstrapping statistical methodology; fetal telomere length; maternal daytime sleepiness; neonatal umbilical cord blood; sleep apnea