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. 2012 Nov;120(5):1085-92.
doi: 10.1097/AOG.0b013e31826eb9d8.

Perinatal outcomes associated with obstructive sleep apnea in obese pregnant women

Judette Louis  1 , Dennis Auckley, Branko Miladinovic, Anna Shepherd, Patricia Mencin, Deepak Kumar, Brian Mercer, Susan Redline
Affiliations

Perinatal outcomes associated with obstructive sleep apnea in obese pregnant women

Judette Louis et al. Obstet Gynecol. 2012 Nov.

Abstract

Objective: To investigate the associations between obstructive sleep apnea (OSA) and maternal and neonatal morbidities in a cohort of obese gravid women.

Methods: Participants were enrolled in a prospective observational study designed to screen for OSA and describe the possible risk factors for and outcomes of OSA among obese (body mass index [BMI, calculated as weight (kg)/[height (m)]2] 30 or higher) pregnant women. Women underwent an overnight sleep study using a portable home monitor. Studies were manually scored by a central masked sleep reading center using American Academy of Sleep Medicine diagnostic criteria. An apnea hypopnea index of 5 or more was considered diagnostic of OSA. Perinatal outcomes were compared between women with and without OSA.

Results: Among 175 women, OSA prevalence was 15.4% (13 mild, 9 moderate, 5 severe). Compared with no OSA (apnea hypopnea index less than 5), the OSA group had a higher BMI (46.8±12.2 compared with 38.1±7.5; P=.002) and more chronic hypertension (55.6% compared with 32.4%, P=.02). Maternal complications included maternal death (n=1, amniotic fluid embolus [no OSA group]) and cardiac arrest (n=1, intraoperative at cesarean delivery [OSA group]). One previable birth and two stillbirths occurred in the no OSA group. Among live births, OSA was associated with more frequent cesarean delivery (65.4% compared with 32.8%; P=.003), preeclampsia (42.3% compared with 16.9%; P=.005), and neonatal intensive care unit admission (46.1% compared with 17.8%; P=.002). After controlling for BMI, maternal age, and diabetes, OSA (odds ratio [OR] 3.55, 95% confidence interval [CI] 1.1-11.3), previous preeclampsia (OR 2.79, 95% CI 1.09-7.19), and hypertension (OR 4.25, 95% CI 1.67-10.77) were associated with development of preeclampsia.

Conclusion: Obstructive sleep apnea among obese pregnant women is associated with more frequent preeclampsia, neonatal intensive care unit admissions, and cesarean delivery.

Level of evidence: II.

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References

    1. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of Obesity and Trends in the Distribution of Body Mass Index Among US Adults, 1999–2010. JAMA: The Journal of the American Medical Association. 2012 Feb 1;307(5):491–7. - PubMed
    1. Finkelstein EA, Khavjou OA, Thompson H, Trogdon JG, Pan L, Sherry B, et al. Obesity and Severe Obesity Forecasts Through 2030. American Journal of Preventive Medicine June. 2012;42(6) - PubMed
    1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of Obesity and Trends in Body Mass Index Among US Children and Adolescents, 1999–2010. JAMA: The Journal of the American Medical Association. 2012 Feb 1;307(5):483–90. - PMC - PubMed
    1. Ovesen P, Rasmussen S, Kesmodel U. Effect of Prepregnancy Maternal Overweight and Obesity on Pregnancy Outcome. Obstetrics & Gynecology. 2011;118(2 Part 1):305–12. doi: 10.1097/AOG.0b013e3182245d49. - DOI - PubMed
    1. Vricella LK, Louis JM, Mercer BM, Bolden N. Impact of morbid obesity on epidural anesthesia complications in labor. American Journal of Obstetrics and Gynecology. 2011;205(4):370.e1–e6. - PubMed

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