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Am J Perinatol 2014; 31(10): 899-904
DOI: 10.1055/s-0033-1363768
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sleep Disordered Breathing in a High-Risk Cohort Prevalence and Severity across Pregnancy

Francesca L. Facco
1   Department of Obstetrics and Gynecology, University of Pittsburgh, Magee Womens Hospital, Chicago, Illinois
,
David W. Ouyang
2   Department of Obstetrics and Gynecology, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Evanston, Illinois
,
Phyllis C. Zee
3   Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
,
William A. Grobman
4   Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
› Author Affiliations
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Publication History

19 April 2013

15 November 2013

Publication Date:
10 February 2014 (online)

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Abstract

Objective The objective of this study was to determine the prevalence and incidence of sleep disordered breathing (SDB) in pregnancy among high-risk women.

Study Design This was a prospective, observational study. We recruited women with a body mass index (BMI) ≥ 30 kg/m2, chronic hypertension, pregestational diabetes, history of preeclampsia, and/or a twin gestation. Objective assessment of SDB was completed between 6 and 20 weeks and again in the third trimester. SDB was defined as an apnea–hypopnea index (AHI) ≥5, and further grouped into severity categories: mild (5–14.9), moderate (15–29.9) and severe (≥30). Subjects who had a normal AHI at the baseline (AHI < 5), but an abnormal study in the third trimester (AHI ≥5) were classified as having “new-onset” SDB.

Results A total of 128 women were recruited. In early pregnancy 21, 6 and 3% had mild, moderate, or severe SDB, respectively. These frequencies increased to 35, 7, and 5% in the third trimester (p < 0.001). About 27% (n = 34) experienced a worsening of SDB during pregnancy; 26 were cases of new-onset SDB, while the other 8 had SDB in early pregnancy that worsened in severity. The incidence of new-onset SDB was 20%. The majority of these new-onset cases were mild.

Conclusions SDB in early pregnancy is common in high-risk women and new-onset SDB occurs in 20% of these women.

Keywords

sleep disordered breathing - sleep apnea - pregnancy