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Association of adverse perinatal outcomes with screening measures of obstructive sleep apnea

Abstract

Objective:

This prospective observational study explored the association of hypertensive disorders of pregnancy and small-for-gestational age with obstructive sleep apnea (OSA) as determined by screening measures for OSA and sleep studies.

Study Design:

Two symptom-based screening questionnaires, the Berlin Questionnaire (BQ) and the Epworth Sleepiness Scale (ESS), were administered to enroll 1509 gravidae. Screen-positive subjects were referred for polysomnography. The primary outcome was the occurrence of either gestational hypertension or preeclampsia. Generalized linear models (GLM) were used to estimate the relative risks of associations.

Result:

One thousand one hundred and fifty-seven subjects were available for outcomes analysis. Screening positive on the BQ was positively associated with hypertensive disorders in GLM models (adjusted relative risk=1.90, 95% confidence interval 1.52 to 2.37).

Conclusion:

In this large prospective trial, GLM modeling suggests that the BQ but not the ESS demonstrated significant association with measured adverse pregnancy outcomes, and specific items predicted these outcomes better than others. However, causative association of BQ with OSA cannot be assumed.

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Acknowledgements

We thank Lata Casturi, RPGST at the Baylor College of Medicine; ResMed for the use of the ResMed ApneaLink devices; and staff and nurses at the People’s Health Center, Casa de Amigos Health Center and Ben Taub Obstetrics Clinic and Antepartum Unit for their support. KM Aagaard was supported by a DP2 award (DP21DP2OD001500-01 NIH Director New Innovator Award). This study was financially supported by the Baylor College of Medicine Department of Obstetrics and Gynecology Resident Research Grant 2011–2012 (to KM Antony). ResMed donated single-use nasal cannulas and oximeter sensors for this study.

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Correspondence to K M Aagaard.

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This paper was previously presented as a poster at the Society of Maternal–Fetal Medicine’s 33rd Annual Meeting—The Pregnancy Meeting, San Francisco, CA, USA, 11–16 February 2013. Abstract Number 670.

Supplementary Information accompanies the paper on the Journal of Perinatology website

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Antony, K., Agrawal, A., Arndt, M. et al. Association of adverse perinatal outcomes with screening measures of obstructive sleep apnea. J Perinatol 34, 441–448 (2014). https://doi.org/10.1038/jp.2014.25

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