Obstructive Sleep Apnea during Pregnancy and Morbidity Outcome

Abstract

Objectives:

Obstructive sleep apnea (OSA) is increasingly a concern for a risk factor of poor pregnancy outcomes. However, to date, most research studies have relied on subjective research such as Epworth Sleepiness Scale (ESS). Therefore, our research design used polysomnography, which is an objective measurement to define OSA in pregnancy. The study aimed to measure the incidence of OSA in pregnancy, to reveal clinical examination which will be objective screening tool for OSA in pregnancy, and prove that OSA is a risk factor of poor pregnancy outcomes.

Methods:

Fifty healthy pregnant women who received antenatal care at Chiangmai University Hospital during October 2012 through April 2013 were measured by physical examination and polysomnography at GA 28th to 32nd weeks, and followed until the end of pregnancy to see the difference of poor pregnancy outcomes in OSA and non-OSA group.

Results:

The incidence of OSA in pregnancy was 12%. OSA related to more overall poor pregnancy outcomes (relative risk [RR] = 5.86 [2.16-15.96], P = .007), more preterm labor (RR = 19.33 [3.89-220.79], P < .001), and more preeclampsia (RR = n/a, P = .012). Friedman tongue position (FTP) equal or more than gr III was considered the screening tool for OSA in pregnancy, which yielded 66.7% sensitivity and 84.1% specificity.

Conclusions:

OSA could lead to a high-risk pregnancy, which should be screened by multidisciplinary teams, to establish diagnosis and treatment for maternal and child health.