Obstructive sleep apnea, gestational hypertension and preeclampsia: a review of the literature

Abstract

Purpose of review: The evidence of a putative causal effect of sleep apnea-induced intermittent hypoxia on the pathogenesis of gestational hypertension and preeclampsia is mounting. The present review presents the evidence of current literature and questions whether an early diagnosis and treatment of obstructive sleep apnea during pregnancy can reduce the risk of preeclampsia.

Recent findings: Although pathophysiological pathways remain to be more clearly defined, recent studies shed light on the association of sleep-disordered breathing, gestational hypertension and preeclampsia. For the first time, a recent prospective study revealed that obstructive sleep apnea increases over the course of pregnancy and that it is common during the third trimester. In this study, age and BMI have been identified as independent predictors of gestational obstructive sleep apnea.

Summary: An association between sleep-disordered breathing, gestational hypertension and preeclampsia has been demonstrated. However, there is a lack of evidence on the effect of continuous positive airway pressure treatment during pregnancy on hypertension and preeclampsia. Further studies are required to ascertain whether continuous positive airway pressure can be a useful adjunct treatment for pregnant women at risk of preeclampsia.