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Obstructive Sleep Apnea Linked to Preeclampsia


 

SAN FRANCISCO — Pregnant women were more likely to have risk factors for obstructive sleep apnea, compared with nonpregnant women, in a study of 4,564 women.

In addition, pregnant women identified to be at risk for sleep apnea were more likely to develop preeclampsia, compared with pregnant women who didn't have sleep apnea risk factors, Dr. Nicole Higgins, an anesthesiologist at Northwestern University, Chicago, and her associates reported in a poster presentation at the annual meeting of the American Society of Anesthesiologists.

About 2% of adult women have obstructive sleep apnea, a condition characterized by obstruction of the upper airway and episodes of apnea and hypopnea during sleep. In an interview, Dr. Higgins attributed the increase in sleep apnea cases to the greater prevalence of obesity. The incidence of obstructive sleep apnea in pregnancy has been unknown.

In the prospective study, 33% of 4,074 pregnant women presenting for delivery and 20% of 490 control women presenting for outpatient surgery screened positive on the Berlin Questionnaire, which identifies patients at increased risk for sleep apnea through questions about snoring and daytime sleepiness.

The researchers found pregnancy doubled the chance for screening positive on the Berlin screen, and pregnant women screening positive on it were four times more likely to develop preeclampsia, compared with pregnant women who screened negative. Those screening positive were significantly shorter, heavier before pregnancy, and heavier during pregnancy than were those with a negative screen.

In the current study, there was a significant correlation between a positive Berlin screen and heavier infant weight (3,475 g vs. 3,374 g if the mother screened negative). A positive Berlin screen also correlated significantly with risk for low 1-minute Apgar scores. About 7% of infants born to mothers who screened positive had 1-minute Apgar scores below 7, compared with 6% of infants if the mother screened negative for sleep apnea.

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