Francesca L Facco1, David W Ouyang2, Phyllis C Zee3, William A Grobman4. 1. Department of Obstetrics and Gynecology, University of Pittsburgh, Magee Womens Hospital, Chicago, Illinois. 2. Department of Obstetrics and Gynecology, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Evanston, Illinois. 3. Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois. 4. Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
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/m(2), 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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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/m(2), 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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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