Racial/ethnic disparities in sleep-disordered breathing during pregnancy in the nuMoM2b study.

Abstract

The aim of this study was to assess the prevalence and severity of sleep-disordered breathing (SDB) across racial/ethnic groups in 3702 pregnant people at 6to15 and 22to31 weeks gestational age, examine whether BMI modifies the association between race/ethnicity and SDB, and investigate whether interventions to reduce weight might reduce racial/ethnic disparities in SDB. Differences by race/ethnicity in SDB prevalence and severity were quantified via linear, logistic, or quasi-Poisson regression. Controlled direct effect was used to estimate whether intervening on BMI would remove/diminish differences by race/ethnicity in SDB severity. This study comprised 61.2% non-Hispanic White (nHW), 11.9% non-Hispanic Black (nHB), 18.5% Hispanic, and 3.7% Asian people. SDB prevalence was higher for nHB compared with nHW pregnant people at 6to15 weeks (oddsratio[OR] 1.81, 95% CI [1.07, 2.97]), whereas at 21to32 weeks, Asian pregnant people had a higher SDB prevalence than nHW (OR 2.2, 95% CI [1.1, 4.0]). The severity of SDB differed across racial/ethnic groups in early pregnancy, with nHB pregnant people having a higher apnea-hypopnea index(AHI)(OR 1.35, 95% CI [1.07, 1.69]) compared with nHW. Having overweight/obesity was associated with ahigherAHI (β=2.36, 95% CI [1.97, 2.84]). Controlleddirecteffectanalyses indicated that in early pregnancy, nHB and Hispanic pregnant people would havea lower AHI compared with nHW people had they had normal weight. This study extends knowledge on racial/ethnic disparities in SDB to a pregnant population.