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Original article
Risk factors for sleep-disordered breathing in pregnancy
  1. Grace W Pien1,2,3,
  2. Allan I Pack1,2,
  3. Nicholas Jackson1,
  4. Greg Maislin1,
  5. George A Macones4,
  6. Richard J Schwab1,2,3
  1. 1Center for Sleep and Circadian Neurobiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2Sleep Medicine Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  3. 3Pulmonary and Critical Care Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  4. 4Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri, USA
  1. Correspondence to Dr Grace W Pien, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Allergy and Asthma Center, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA; gpien1{at}jhmi.edu

Abstract

Rationale Symptoms of sleep-disordered breathing (SDB) are common among pregnant women, and several studies link SDB symptoms with gestational hypertension and preeclampsia. However, few prospective studies objectively measuring SDB during pregnancy have been performed.

Objectives We performed a prospective cohort study examining risk factors for third trimester SDB in pregnant women.

Measurements and methods 105 pregnant women from the Hospital of the University of Pennsylvania obstetrics practices completed first and third trimester overnight polysomnography studies. We examined whether the number of SDB events per hour of sleep increased during pregnancy. We performed unadjusted and multivariable logistic regression analyses to estimate the effects of usual and pregnancy-specific characteristics on development of third trimester obstructive sleep apnoea (OSA). In secondary analyses, we examined the relationship between objectively measured SDB, hypertensive disorders of pregnancy, and other adverse maternal-fetal outcomes.

Main results Mean Apnoea-Hypopnoea Index increased from 2.07 (SD 3.01) events/h at baseline (first trimester) to 3.74 (SD 5.97) in the third trimester (p=0.009). 10.5% of women had OSA in the first trimester. By the third trimester, 26.7% of women had OSA. In multivariable analyses, first trimester body mass index (BMI) and maternal age were significantly associated with third trimester OSA.

Conclusions Third trimester OSA is common. Risk factors for third trimester OSA among women without baseline SDB include higher baseline BMI and maternal age.

  • Sleep Apnoea
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