Sleep Apnea May Affect Birth Outcome

BY DIANA MAHONEY
Elsevier Global Medical News

MINNEAPOLIS – Women with sleep-disordered breathing have an increased likelihood of adverse pregnancy outcomes, but it is unclear whether the heightened risk can be attributed primarily to the breathing disorder or to obesity, reported lead investigator Dr. Francesca L. Facco.

Sleep disordered breathing (SDB) occurs in approximately 2% of the female population and has been linked to cardiovascular and metabolic morbidities and mortality in nonpregnant populations, said Dr. Facco of Northwestern University in Chicago. However, “few studies have examined the relationship between abnormal respiratory patterns or quality of ventilation during sleep in pregnancy and adverse obstetrical outcomes, which is what we sought to do in this investigation,” she said at the annual meeting of the Associated Professional Sleep Societies.

Toward this end, Dr. Facco and her colleagues conducted a retrospective cohort study, using ICD-9 codes to identify women who had a delivery and an in-laboratory polysomnogram at their institution between January 2000 and June 2009. They reviewed the medical charts of 150 patients and abstracted data on demographics, sleep study results, and pregnancy outcomes.

The study’s primary outcome was adverse pregnancy outcome, which was defined as pregnancy-induced hypertension, gestational diabetes, and early preterm birth (at or before 34 weeks’ gestation), Dr. Facco said. The apnea-hypopnea index (AHI) was used to classify the presence and degree of SDB, with an AHI of fewer than 5 breathing pauses per hour indicating no SDB, an AHI of 5-14.9 pauses per hour indicating mild to moderate SDB, and an AHI of 15 or more pauses per hour suggesting a severe condition, she said.