Abstract
Define the prevalence of OSA in a population of obese pregnant women. Secondary objectives were to assess its obstetric consequences and define its risk factors in this population. This single-center prospective study took place at the Lille University Hospital from 2010 to 2016 and included pregnant women with a body mass index (BMI) > 35 kg/m2. They underwent polysomnography (type 1 sleep testing) between 24 and 32 weeks of gestation to diagnose OSA. Clinical, obstetric, and fetal data were collected monthly and at delivery. We compared the groups with and without OSA and calculated its prevalence. This study included 67 women with a mean BMI of 42.4 ± 6.2 kg/m2. Among them, 29 had OSA, for a prevalence of 43.3% (95% confidence interval, 31.4-55.2); it was mild or moderate in 25 women and severe in 4. Comparison of the two groups showed that women in the OSA group were older (31.9 ± 4.7 years vs 29.5 ± 4.8 years, P = .045), had chronic hypertension more frequently (37.9% vs 7.9%, P = .0027), and had a higher mean BMI (43.8 ± 6.2 kg/m2 vs 41.2 ± 6 kg/m2, P = .045). During pregnancy, they developed gestational diabetes more often (48.3% vs 23.7%, P = .04). No significant differences were observed for any of the other criteria studied. The prevalence of OSA was high in our study, and women with it developed gestational diabetes during pregnancy more often. No other obstetric complications were observed.
Highlights
Obesity in pregnant women is accompanied by an increase in pregnancy-related vascular complications such as preeclampsia, pregnancy-related hypertension, and gestational diabetes [6, 7]
Comparison of the two groups showed that women in the Obstructive sleep apnea (OSA) group were older (31.9 ± 4.7 years vs 29.5 ± 4.8 years, P = .045), had chronic hypertension more frequently (37.9% vs 7.9%, P = .0027), and had a higher mean body mass index (BMI) (43.8 ± 6.2 kg/m2 vs 41.2 ± 6 kg/m2, P = .045)
The prevalence of OSA was high in our study, and women with it developed gestational diabetes during pregnancy more often
Summary
Obesity in pregnant women is accompanied by an increase in pregnancy-related vascular complications such as preeclampsia, pregnancy-related hypertension, and gestational diabetes [6, 7]. Obesity in pregnant women may be a risk factor for the development of sleep apnea, which may further increase the risk of pregnancy complications. OSA during pregnancy has been studied often. The exact prevalence among pregnant women remains unknown, especially because it is underestimated and underdiagnosed in this population because of its nonspecific clinical symptoms during pregnancy (asthenia, nonrestorative sleep, snoring in the third trimester) that may be trivialized by both women and clinicians [16, 17]. Because many of the studies about OSA and pregnancy have not used polysomnography, it may well have been either under- or overdiagnosed
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