Abstract
In nonpregnant populations, sleep-disordered breathing (SDB) has been associated with
cardiovascular and metabolic disease. Few studies have examined the relationship between
SDB and adverse pregnancy outcomes (APO). The objective of this study was to examine
the association between SDB and APO. Women who had a delivery as well as an in-laboratory
polysomnogram (PSG) were identified. Demographics, PSG results, and pregnancy outcomes
were abstracted from the medical record. Absence of SDB was defined as an apnea hypopnea
index (AHI) of <5, mild SDB as an AHI of 5 to 14.9, and moderate to severe SDB as
an AHI of ≥15. The primary outcome was a composite measure of APO: pregnancy-related
hypertension, gestational diabetes, or preterm birth ≤34 weeks. We identified 143
women who had undergone a PSG and a delivery. Increasing severity of SDB was associated
with an increasing risk of the composite APO: AHI <5, 18.1%; AHI 5 to 14.9, 23.5%;
AHI ≥15, 38.5% (p = 0.038). Obese women (body mass index ≥30) with moderate to severe SDB had the highest
rate of APO, 41.7%. SDB, especially moderate to severe disease, may be associated
with APO. However, it is unclear if SDB is a risk factor for APO independent of obesity.
Keywords
sleep disordered breathing - sleep apnea - pregnancy
