title: Serum Progesterone Levels in Pregnant Women with Obstructive Sleep Apnea: A Case Control Study.
abstract: Pregnancy is a risk factor for sleep disordered breathing, including obstructive sleep apnea (OSA). Progesterone, one of the key hormones in pregnancy, a known respiratory drive stimulant, increases ventilation and may protect against OSA. We aimed to examine the relationship between circulating progesterone and OSA, after accounting for body weight and gestational age.
  
  
  
  A case control study was conducted of pregnant women with OSA and those at low risk for the disorder. Cases were identified by ICD-9 code and review of medical record. Controls were identified if they scored zero (never) for snoring, apnea, and gasping on the multivariable apnea prediction index questionnaire immediately following delivery. Subjects with available stored first and/or second trimester residual serum samples were then included in this study and serum analyzed for progesterone. Raw progesterone levels were adjusted for the effects of gestational age and maternal weight.
  
  
  
  Twenty-seven cases and 64 controls with available serum were identified. Women with OSA had greater maternal weight and higher rates of related comorbidities, compared to controls. Progesterone levels correlated positively with gestational age and negatively with greater weight. Progesterone levels, adjusted for gestational age and maternal weight and expressed as multiples of median (MoM), were significantly lower in OSA cases compared to controls in both the first trimester (MoM = 0.71, confidence interval [95% CI] 0.60-0.83) relative to the MoM in controls of 1.00. In the second trimester levels were also lower in OSA cases (MoM = 0.84, 95% CI 0.73-0.96) compared to the MoM of 1.00 in controls.
  
  
  
  Progesterone levels, after accounting for weight and gestational age, were lower in women with OSA than controls. Progesterone may play a protective role against OSA.
authors.affiliation: 1 Department of Medicine, Warren Alpert Medical School of Brown University , Providence, Rhode Island.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lee
authors.affiliation: 2 Department of Pathology and Laboratory Medicine, Women & Infants Hospital of Rhode Island , Providence, Rhode Island.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Eklund
authors.affiliation: 1 Department of Medicine, Warren Alpert Medical School of Brown University , Providence, Rhode Island.|2 Department of Pathology and Laboratory Medicine, Women & Infants Hospital of Rhode Island , Providence, Rhode Island.
authors.forename: Geralyn
authors.initials: G
authors.lastname: Lambert-Messerlian
authors.affiliation: 1 Department of Medicine, Warren Alpert Medical School of Brown University , Providence, Rhode Island.|2 Department of Pathology and Laboratory Medicine, Women & Infants Hospital of Rhode Island , Providence, Rhode Island.
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Palomaki
authors.affiliation: 3 Department of Clinical and Academic Quality Initiatives, Rhode Island Hospital , Providence, Rhode Island.
authors.forename: Kristen
authors.initials: K
authors.lastname: Butterfield
authors.affiliation: 4 Women's Medicine Collaborative, The Miriam Hospital , Providence, Rhode Island.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Curran
authors.affiliation: 1 Department of Medicine, Warren Alpert Medical School of Brown University , Providence, Rhode Island.|4 Women's Medicine Collaborative, The Miriam Hospital , Providence, Rhode Island.|5 Department of Medicine, The Miriam Hospital , Providence, Rhode Island.
authors.forename: Ghada
authors.initials: G
authors.lastname: Bourjeily
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D038801:International Classification of Diseases; D016014:Linear Models; D017286:Polysomnography; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011261:Pregnancy Trimester, First / Q000097:blood; D011262:Pregnancy Trimester, Second / Q000097:blood; D011374:Progesterone / Q000097:blood*; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood*; D055815:Young Adult
chemical_list: D011374:Progesterone
keywords: obesity; obstructive sleep apnea; pregnancy; progesterone