S K Sharma1, A Nehra2, S Sinha2, M Soneja2, K Sunesh3, V Sreenivas4, D Vedita5. 1. Department of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India. sksharma.aiims@gmail.com. 2. Department of Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India. 3. Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, 110029, India. 4. Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India. 5. Department of Radio-Diagnosis, PGIMS, Rohtak, 124001, Haryana, India.
Abstract
PURPOSE: Sleep disturbances such as insomnia, nocturnal awakenings, restless legs syndrome, habitual snoring, and excessive daytime sleepiness are frequent during pregnancy, and these have been linked to adverse maternal and fetal outcomes. METHODS: A prospective observational study was performed in high-risk Indian pregnant women. We used modified Berlin questionnaire (MBQ), Pittsburgh sleep quality index (PSQI), International Restless Legs Syndrome Study Group 2011 criteria, and Epworth sleepiness scale to diagnose various sleep disorders, such as symptomatic OSA, poor sleep quality and insomnia, RLS, and excessive daytime sleepiness, respectively, in successive trimesters of pregnancy. Outcome variables of interest were development of gestational hypertension (GH), gestational diabetes mellitus (GDM), and cesarean delivery (CS); the Apgar scores; and low birth weight (LBW). The relationship between sleep disorders and outcomes was explored using logistic regression analysis. RESULTS: Outcome data were obtained in 209 deliveries. As compared to nonsnorers, women who reported snoring once, twice, and thrice or more had odds ratios for developing GH-4.0 (95 % CI 1.3-11.9), 1.5 (95 % CI 0.5-4.5), and 2.9 (95 % CI 1.0-8.2) and for undergoing CS-5.3 (95 % CI 1.7-16.3), 4.9 (95 % CI 1.8-13.1), and 5.1 (95 % CI 1.9-14.9), respectively. Pregnant women who were persistently positive on MBQ had increased odds for GH and CS. CONCLUSIONS: Snoring and high-risk MBQ in pregnant women are strong risk factors for GH and CS. In view of the significant morbidity and health care costs, simple screening of pregnant women with questionnaires such as MBQ may have clinical utility.
PURPOSE: Sleep disturbances such as insomnia, nocturnal awakenings, restless legs syndrome, habitual snoring, and excessive daytime sleepiness are frequent during pregnancy, and these have been linked to adverse maternal and fetal outcomes. METHODS: A prospective observational study was performed in high-risk Indian pregnant women. We used modified Berlin questionnaire (MBQ), Pittsburgh sleep quality index (PSQI), International Restless Legs Syndrome Study Group 2011 criteria, and Epworth sleepiness scale to diagnose various sleep disorders, such as symptomatic OSA, poor sleep quality and insomnia, RLS, and excessive daytime sleepiness, respectively, in successive trimesters of pregnancy. Outcome variables of interest were development of gestational hypertension (GH), gestational diabetes mellitus (GDM), and cesarean delivery (CS); the Apgar scores; and low birth weight (LBW). The relationship between sleep disorders and outcomes was explored using logistic regression analysis. RESULTS: Outcome data were obtained in 209 deliveries. As compared to nonsnorers, women who reported snoring once, twice, and thrice or more had odds ratios for developing GH-4.0 (95 % CI 1.3-11.9), 1.5 (95 % CI 0.5-4.5), and 2.9 (95 % CI 1.0-8.2) and for undergoing CS-5.3 (95 % CI 1.7-16.3), 4.9 (95 % CI 1.8-13.1), and 5.1 (95 % CI 1.9-14.9), respectively. Pregnant women who were persistently positive on MBQ had increased odds for GH and CS. CONCLUSIONS: Snoring and high-risk MBQ in pregnant women are strong risk factors for GH and CS. In view of the significant morbidity and health care costs, simple screening of pregnant women with questionnaires such as MBQ may have clinical utility.
Entities:
Keywords:
Cesarean delivery; Gestational hypertension; Modified Berlin questionnaire; Obstructive sleep apnea; Pittsburgh sleep quality index; Restless legs syndrome
Authors: J O Ramirez; S A S Cabrera; H Hidalgo; S G Cabrera; M Linnebank; C L Bassetti; U Kallweit Journal: Sleep Med Date: 2013-07-23 Impact factor: 3.492
Authors: Galit Levi Dunietz; Lynda D Lisabeth; Kerby Shedden; Q Afifa Shamim-Uzzaman; Alexandra S Bullough; Mark C Chames; Marc F Bowden; Louise M O'Brien Journal: J Clin Sleep Med Date: 2017-07-15 Impact factor: 4.062
Authors: Kim E Innes; Sahiti Kandati; Kathryn L Flack; Parul Agarwal; Terry Kit Selfe Journal: J Womens Health (Larchmt) Date: 2016-02-25 Impact factor: 2.681
Authors: Galit Levi Dunietz; Kerby Shedden; Enrique F Schisterman; Lynda D Lisabeth; Marjorie C Treadwell; Louise M O'Brien Journal: Paediatr Perinat Epidemiol Date: 2018-09-28 Impact factor: 3.980
Authors: Abigail M Pauley; Ginger A Moore; Scherezade K Mama; Peter Molenaar; Danielle Symons Downs Journal: J Clin Sleep Med Date: 2020-04-15 Impact factor: 4.062
Authors: Philipp Fassbender; Frank Herbstreit; Matthias Eikermann; Helmut Teschler; Jürgen Peters Journal: Dtsch Arztebl Int Date: 2016-07-11 Impact factor: 5.594