Snoring during pregnancy could mean greater risk of high blood pressure

A new study discusses how snoring during pregnancy may indicate a risk of high-blood pressure and preeclampsia.

Objective

This study aimed to prospectively examine the impact of chronic vs pregnancy-onset habitual snoring on gestational hypertension, preeclampsia, and gestational diabetes.

Study design

Third-trimester pregnant women were recruited from a large, tertiary medical center from March 2007 through December 2010 and screened for the presence and duration of habitual snoring, as a known marker for sleep-disordered breathing. Clinical diagnoses of gestational hypertension, preeclampsia, and gestational diabetes were obtained.

Results

Of 1719 pregnant women, 34% reported snoring, with 25% reporting pregnancy-onset snoring. After adjusting for confounders, pregnancy-onset, but not chronic, snoring was independently associated with gestational hypertension (odds ratio, 2.36; 95% confidence interval, 1.48–3.77; P < .001) and preeclampsia (odds ratio, 1.59; 95% confidence interval, 1.06–2.37; P = .024) but not gestational diabetes.

Conclusion

New-onset snoring during pregnancy is a strong risk factor for gestational hypertension and preeclampsia. In view of the significant morbidity and health care costs associated with hypertensive diseases of pregnancy, simple screening of pregnant women may have clinical utility.

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Perinatal Outcomes Associated With Obstructive Sleep Apnea in Obese Pregnant Women

In obese women, sleep apnea increases risk of NICU admission from 17% to 46%, cesarean  33 to 65% and preeclampsia 17 to 42%! JR

Perinatal Outcomes Associated With Obstructive Sleep Apnea in Obese Pregnant Women

Louis, Judette MD, MPH; Auckley, Dennis MD; Miladinovic, Branko PhD; Shepherd, Anna BSN; Mencin, Patricia BBA; Kumar, Deepak MD; Mercer, Brian MD; Redline, Susan MD, MPH

Published Ahead-of-Print

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 ofSleep 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, nine moderate, five 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

Abstract here