open access

Vol 88, No 4 (2020)
ORIGINAL PAPERS
Published online: 2020-07-15
Submitted: 2020-03-09
Accepted: 2020-04-18
Get Citation

An assessment of risks associated with obstructive sleep apnea and its relationship with adverse health outcomes among pregnant women. A multi-hospital based study

Nitin Joseph, Shreeshaina, Shivani Bhat Loliem, Vinod Kumar Gundi, Mrudula Bhargav Herambapura Subramanya, Shreyashree Belthur Shashidhar
DOI: 10.5603/ARM.a2020.0104
·
Pubmed: 32869266
·
Adv Respir Med 2020;88(4):327-334.

open access

Vol 88, No 4 (2020)
ORIGINAL PAPERS
Published online: 2020-07-15
Submitted: 2020-03-09
Accepted: 2020-04-18

Abstract

Introduction: Physiological changes in pregnancy increase the vulnerability of antenatal women to develop obstructive sleep apnoea (OSA). It is a known cause of several adverse health outcomes in pregnancy. Objectives: To assess the risk status of OSA in pregnant women and to study its association with adverse maternal outcomes, fatigability, and daytime sleepiness. Material and methods: Pregnant women were interviewed to assess for the risk of OSA, fatigability, and daytime sleepiness. STOP BANG, the fatigue severity scale, and the Epworth sleepiness scale were used to assess these parameters. Results: The mean age of the 214 participants was 27.2 ± 4.7 years. 7 (3.3%) participants had a history of snoring louder than the volume of normal talking, or of being loud enough to be heard past closed doors. A moderate risk status of OSA was present among 3 (1.4%) participants. 45 (21.0%) pregnancies were high risk in nature. The risk status of OSA was associated with a high risk status of pregnancies among the participants (p = 0.0088). 41 (19.2%) participants had a history of significant fatigue over the previous week of the study. 7 (3.3%) participants reported mild to severe excessive daytime sleepiness. A history of snoring loudly (p = 0.0179) and a OSA risk status (p = 0.0027) was associated with excessive daytime sleepiness. Conclusions: A risk status for OSA was associated with a high risk pregnancy status and excessive daytime sleepiness among pregnant women in the current setting. Therefore, pregnant women with these conditions need to be evaluated for OSA. They also need to be suitably managed to ensure the healthy well-being of the mother and the baby.

Abstract

Introduction: Physiological changes in pregnancy increase the vulnerability of antenatal women to develop obstructive sleep apnoea (OSA). It is a known cause of several adverse health outcomes in pregnancy. Objectives: To assess the risk status of OSA in pregnant women and to study its association with adverse maternal outcomes, fatigability, and daytime sleepiness. Material and methods: Pregnant women were interviewed to assess for the risk of OSA, fatigability, and daytime sleepiness. STOP BANG, the fatigue severity scale, and the Epworth sleepiness scale were used to assess these parameters. Results: The mean age of the 214 participants was 27.2 ± 4.7 years. 7 (3.3%) participants had a history of snoring louder than the volume of normal talking, or of being loud enough to be heard past closed doors. A moderate risk status of OSA was present among 3 (1.4%) participants. 45 (21.0%) pregnancies were high risk in nature. The risk status of OSA was associated with a high risk status of pregnancies among the participants (p = 0.0088). 41 (19.2%) participants had a history of significant fatigue over the previous week of the study. 7 (3.3%) participants reported mild to severe excessive daytime sleepiness. A history of snoring loudly (p = 0.0179) and a OSA risk status (p = 0.0027) was associated with excessive daytime sleepiness. Conclusions: A risk status for OSA was associated with a high risk pregnancy status and excessive daytime sleepiness among pregnant women in the current setting. Therefore, pregnant women with these conditions need to be evaluated for OSA. They also need to be suitably managed to ensure the healthy well-being of the mother and the baby.

Get Citation

Keywords

OSA; pregnant mothers; fatigue; day time sleepiness

About this article
Title

An assessment of risks associated with obstructive sleep apnea and its relationship with adverse health outcomes among pregnant women. A multi-hospital based study

Journal

Advances in Respiratory Medicine

Issue

Vol 88, No 4 (2020)

Pages

327-334

Published online

2020-07-15

DOI

10.5603/ARM.a2020.0104

Pubmed

32869266

Bibliographic record

Adv Respir Med 2020;88(4):327-334.

Keywords

OSA
pregnant mothers
fatigue
day time sleepiness

Authors

Nitin Joseph
Shreeshaina
Shivani Bhat Loliem
Vinod Kumar Gundi
Mrudula Bhargav Herambapura Subramanya
Shreyashree Belthur Shashidhar

References (29)
  1. Hines J. Alaska Sleep Education Center. Snoring, sleep apnea and pregnancy. Available at: https://www.alaskasleep.com/blog/snoring-sleep-apnea-and-pregnancy. [Last accessed at: 09.2019].
  2. Izci-Balserak B, Zhu B, Gurubhagavatula I, et al. A screening algorithm for obstructive sleep apnea in pregnancy. Ann Am Thorac Soc. 2019; 16(10): 1286–1294.
  3. Bourjeily G, Danilack V, Bublitz M, et al. Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort. Sleep Med. 2017; 38: 50–57.
  4. Champagne KA, Kimoff JR, Barriga PC, et al. Sleep disordered breathing in women of child bearing age and during pregnancy. Indian J Med Res. 2010; 131: 285–301.
  5. Dominguez JE, Lockhart EM, Miskovic A, et al. Recognition of obstructive sleep apnea in pregnancy survey. Int J Obstet Anesth. 2016; 26: 85–87.
  6. Kapur V, Auckley D, Chowdhuri S, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017; 13(03): 479–504.
  7. Chung F, Subramanyam R, Liao P, et al. High STOP-BANG score indicates a high probability of obstructive sleep apnoea. Survey of Anesthesiology. 2012; 56(6): 312.
  8. Louis J, Pien GW. Obstructive sleep apnea in pregnancy. Available at: https://www.uptodate.com/contents/obstructive-sleep-apnea-in-pregnancy. [Last accessed at: 09.2019].
  9. Tantrakul V, Sirijanchune P, Panburana P, et al. Screening of obstructive sleep apnea during pregnancy: differences in predictive values of questionnaires across trimesters. J Clin Sleep Med. 2015; 11(02): 157–163.
  10. Lockhart E, Abdallah AB, Tuuli M, et al. Obstructive sleep apnea in pregnancy. Obstet Gynecol. . 2015; 126(1): 93–102.
  11. Sarberg M, Svanborg E, Wiréhn AB, et al. Snoring during pregnancy and its relation to sleepiness and pregnancy outcome — a prospective study. BMC Pregnancy and Childbirth. 2014; 14(1).
  12. Puapornpong P, Neruntarat C, Manolerdthewan W. The prevalence of snoring in Thai pregnant women. J Med Assoc Thai. 2010; 93(Suppl 2): S102–105.
  13. Facco F, Kramer J, Ho K, et al. Sleep disturbances in pregnancy. Obstet Gynecol. . 2010; 115(1): 77–83.
  14. Ismail M, Kumar R, Masood T, et al. Prevalence of obstructive sleep apnea in pregnancy: A hospital based study. Global Journal of Medicine and Public Health. 2015; 4: 1–5.
  15. Lintott NC, Zyl DGV, Burke JL. Obstructive sleep apnoea in pregnancy and its association with pre-eclampsia. Southern African Journal of Anaesthesia and Analgesia. 2016; 23(1): 6–10.
  16. Tantrakul V, Numthavaj P, Guilleminault C, et al. Performance of screening questionnaires for obstructive sleep apnea during pregnancy: A systematic review and meta-analysis. Sleep Med Rev. . 2017; 36: 96–106.
  17. Izquierdo F, Izquierdo L, Blue N, et al. Screening for obstructive sleep apnea during pregnancy in rural New Mexico [35H]. Obstetrics & Gynecology. 2018; 131.
  18. Pien G, Pack A, Jackson N, et al. Risk factors for sleep-disordered breathing in pregnancy. Thorax. 2013; 69(4): 371–377.
  19. Fung A, Wilson D, Lappas M, et al. Effects of maternal obstructive sleep apnoea on fetal growth: a prospective cohort study. PLoS ONE. 2013; 8(7): e68057.
  20. Skoczylas M, Lęgowik A, Krawczyk P, et al. Risk assessment of obstructive sleep apnea in third trimester of pregnancy. Ginekologia i Poloznictwo. 2015; 35: 43–52.
  21. Venkata C, Venkateshiah SB. Sleep-Disordered breathing during pregnancy. Am Board Fam Med. . 2009; 22(2): 158–168.
  22. Dominguez J, Krystal A, Habib A. Obstructive sleep apnea in pregnant women. Anesth Analg. . 2018; 127(5): 1167–1177.
  23. Rice J, Larrabure-Torrealva G, Fernandez M, et al. High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women. BMC Pregnancy and Childbirth. 2015; 15(1).
  24. Li L, Zhao K, Hua J, et al. Association between sleep-disordered breathing during pregnancy and maternal and fetal outcomes: an updated systematic review and meta-analysis. Frontiers in Neurology. 2018; 9.
  25. Bourjeily G, Ankner G, Mohsenin V. Sleep-disordered breathing in pregnancy. Clinics in Chest Medicine. 2011; 32(1): 175–189.
  26. O’Keeffe M, St-Onge MP. Sleep duration and disorders in pregnancy: implications for glucose metabolism and pregnancy outcomes. International Journal of Obesity. 2012; 37(6): 765–770.
  27. Tasali E, Leproult R, Ehrmann DA, et al. Slow-wave sleep and the risk of type 2 diabetes in humans. Proc Natl Acad Sci USA. . 2008; 105(3): 1044–1049.
  28. Hermans M, Ahn S, Mahadeb Y, et al. Sleep apnoea syndrome and 10-year cardiovascular risk in females with type 2 diabetes: relationship with insulin secretion and insulin resistance. Diabetes Metab Res Rev. . 2013; 29(3): 227–234.
  29. Guilleminault C, Kreutzer M, Chang J. Pregnancy, sleep disordered breathing and treatment with nasal continuous positive airway pressure. Sleep Medicine. 2004; 5(1): 43–51.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl