Abstract
ObjectiveTo examine the prevalence of snoring during pregnancy and its effects on key pregnancy outcomes.MethodsPregnant women were consecutively recruited in their first trimester. Habitual snoring was screened by using a questionnaire in the 1st and 3rd trimester, respectively. According to the time of snoring, participants were divided into pregnancy onset snorers, chronic snorers and non-snorers. Logistic regressions were performed to examine the associations between snoring and pregnancy outcomes.ResultsOf 3 079 pregnant women, 16.6% were habitual snorers, with 11.7% were pregnancy onset snorers and 4.9% were chronic snorers. After adjusting for potential confounders, chronic snorers were independently associated with gestational diabetes mellitus (GDM) (RR 1.66, 95%CI 1.09–2.53). Both pregnancy onset and chronic snorers were independently associated with placental adhesion (RR 1.96, 95%CI 1.17–3.27, and RR 2.33, 95%CI 1.22–4.46, respectively). Pregnancy onset snorers were at higher risk of caesarean delivery (RR 1.37, 95%CI 1.09–1.73) and having macrosomia (RR 1.54, 95%CI 1.05–2.27) and large for gestational age (LGA) (RR 1.71, 95%CI 1.31–2.24) infants. In addition, being overweight or obese before pregnancy plays an important role in mediating snoring and adverse pregnancy outcomes.ConclusionsMaternal snoring may increase the risk of adverse pregnancy outcomes, and being overweight or obese before pregnancy with snoring is remarkable for researchers. Further studies are still needed to confirm our results.
Highlights
Sleep-disordered breathing (SDB) is prevalent among adults, and it is considered as a public health problem worldwide [1]
After adjusting for potential confounders, chronic snorers were independently associated with gestational diabetes mellitus (GDM) (RR 1.66, 95%confidence interval (CI) 1.09–2.53)
Pregnancy onset snorers were at higher risk of caesarean delivery (RR 1.37, 95%CI 1.09–1.73) and having macrosomia (RR 1.54, 95%CI 1.05– 2.27) and large for gestational age (LGA) (RR 1.71, 95%CI 1.31–2.24) infants
Summary
Sleep-disordered breathing (SDB) is prevalent among adults, and it is considered as a public health problem worldwide [1]. Pregnancy physiology predisposes women to the development of airflow limitations during sleep, and sleep-disordered breathing such as snoring and OSA increases the risk of airflow limitations. Pregnant women with snoring or OSA were more likely to have airflow limitations than non-pregnant population [9,10]. Studies demonstrated that snoring habit was associated with adverse pregnancy outcomes, including GDM, gestational hypertension, preeclampsia, cesarean delivery [11,12,13,14,15], preterm birth, low birth weight (LBW), small for gestational age (SGA) [16,17,18,19,20,21] and so on. A prospective study including 105 pregnant women found no relationship between SDB and adverse pregnancy outcomes [22]. Redhead K et al doubted whether SDB can really cause adverse pregnancy outcomes [23]
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