Snoring, Witnessed Sleep Apneas, and Pregnancy-Induced Hypertension

Abstract

As many as 1 in 4 pregnant women snore habitually in the last week of pregnancy, and a study from Sweden has claimed an increased risk of both pregnancy-induced hypertension and fetal growth retardation in such women. The present study examined the association between self-reported snoring and witnessed sleep apneas on the one hand and pregnancy-induced hypertensive disease on the other in an Argentinian population of 447 women with singleton pregnancies who responded to a questionnaire administered on the day of delivery. Habitual snoring was reported by 7% of respondents, whereas more than one-fourth of those questioned (28%) acknowledged snoring at some time during pregnancy. Women who snored were more obese before pregnancy, gained more weight during gestation, and reported more frequently witnessed apnea than women who did not snore. In addition, snorers more often experienced daytime sleepiness. None of the women had used sedatives while pregnant. Pregnancy-induced hypertensive disease was documented in 42% of women who had snored at some time during pregnancy and in 27% of those who had never snored. The crude odds ratio (OR) for pregnancy-induced hypertensive disease in snorers was 2.01 (95% confidence interval [CI], 1.33–3.06), and increased with the frequency of snoring. The OR was 1.82 (95% CI, 1.16–2.84) when adjusting for prepregnancy body mass index, weight gain, smoking, alcohol use, and age. Witnessed sleep apneas also were associated with pregnancy-induced hypertension (OR, 8.00; 95% CI, 1.72–23.55). No relationship was found between snoring and delivery of a small-for-gestational-age infant. These findings lead the investigators to believe that snoring or sleep apnea could help to explain the development of pregnancy-induced hypertensive disorders in obese women.