High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women.
BACKGROUND
Obstructive sleep apnea (OSA), a common and serious disorder in which breathing repeatedly stops during sleep, is associated with excess weight and obesity. Little is known about the co-occurrence of OSA among pregnant women from low and middle-income countries.


METHODS
We examined the extent to which maternal pre-pregnancy overweight or obesity status are associated with high risk for OSA, poor sleep quality, and excessive daytime sleepiness in 1032 pregnant women in Lima, Peru. The Berlin questionnaire was used to identify women at high risk for OSA. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to examine sleep quality and excessive daytime sleepiness, respectively. Multinomial logistic regression procedures were employed to estimate odds ratios (aOR) and 95% confidence intervals (CI) adjusted for putative confounding factors.


RESULTS
Compared with lean women (<25 kg/m(2)), overweight women (25-29.9 kg/m(2)) had 3.69-fold higher odds of high risk for OSA (95% CI 1.82-7.50). The corresponding aOR for obese women (≥30 kg/m(2)) was 13.23 (95% CI: 6.25-28.01). Obese women, as compared with their lean counterparts had a 1.61-fold higher odds of poor sleep quality (95% CI: 1.00-2.63).


CONCLUSIONS
Overweight or obese pregnant women have increased odds of sleep disorders, particularly OSA. OSA screening and risk management may be indicated among pregnant women in low and middle income countries, particularly those undergoing rapid epidemiologic transitions characterized by increased prevalence of excessive adult weight gain.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA. jraven93@aol.com.
Jayne R
JR
Rice
Instituto Nacional Materno Perinatal de Lima, Lima, Peru. gloria.larrabure@gmail.com.|Departamentos de Medicina y Ginecología y Obstetricia Universidad Nacional Universidad Nacional Mayor de San Marcos, Lima, Peru. gloria.larrabure@gmail.com.
Gloria T
GT
Larrabure-Torrealva
Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA. mluquefe@hsph.harvard.edu.
Miguel Angel
MA
Luque Fernandez
Asociación Civil de Proyectos en Salud, AC.PROESA, Lima, Peru. mirtha_grande@hotmail.com.
Mirtha
M
Grande
Instituto Nacional Materno Perinatal de Lima, Lima, Peru. vickymotta@yahoo.com.
Vicky
V
Motta
Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA. ybarrios@hsph.harvard.edu.
Yasmin V
YV
Barrios
Universidad de Ciencias Aplicadas, Lima, Peru. sixtosanchez@gmail.com.|Asociación Civil de Proyectos en Salud, AC.PROESA, Lima, Peru. sixtosanchez@gmail.com.
Sixto
S
Sanchez
Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA. bgelaye@hsph.harvard.edu.
Bizu
B
Gelaye
Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, , 02115, USA. mawilliams@hsph.harvard.edu.
Michelle A
MA
Williams
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D050177:Overweight / Q000175:diagnosis / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D017286:Polysomnography / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D011256:Pregnancy Outcome; D018570:Risk Assessment; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires