Research
Obstetrics
Obstructive sleep apnea and the risk of adverse pregnancy outcomes

https://doi.org/10.1016/j.ajog.2011.09.006Get rights and content

Objective

We examined the risk of adverse pregnancy outcomes, including low birthweight (LBW), preterm birth, small for gestational age (SGA), cesarean section (CS), low Apgar score (at 5 minutes after delivery), and preeclampsia in pregnant women with and without obstructive sleep apnea (OSA).

Study Design

Our subjects included 791 women with OSA and 3955 randomly selected women without OSA. We performed conditional logistic regression analyses to examine the risks of adverse pregnancy outcomes between women with and without OSA.

Results

Compared with women without OSA, adjusted odds ratios for LBW, preterm birth, SGA infants, CS, and preeclampsia in women with OSA were 1.76 (95% confidence interval [CI], 1.28–2.40), 2.31 (95% CI, 1.77–3.01), 1.34 (95% CI, 1.09–1.66), 1.74 (95% CI, 1.48–2.04), and 1.60 (95% CI, 2.16–11.26), respectively.

Conclusion

Pregnant women with OSA are at increased risk for having LBW, preterm, and SGA infants, CS, and preeclampsia, compared with pregnant women without OSA.

Section snippets

Database

We linked 2 nationwide, population-based datasets and used the resulting compilation for our analyses. In March 1995, Taiwan initiated its National Health Insurance (NHI) program to finance health care for all its citizens. Taiwan's NHI has a unique combination of characteristics: universal coverage, a single-payer payment system with the government as the sole insurer, unrestricted access to any medical institution of the patient's choice, and a wide variety of providers including primary care

Results

The mean age of the 4746 sampled women was 30.3 ± 4.4 years (SD; range, 14–45 years). The mean birthweight for women with OSA and women without OSA were 3063 ± 584 g (SD; range, 361–4650 g) and 3147 ± 418 g (SD; range, 1426–4760 g), respectively. Moreover, the mean gestational age for women with OSA and women without OSA were 38 ± 2.28 weeks (SD; range, 24–41 weeks) and 38 ± 1.45 weeks (SD; range, 29–43 weeks), respectively.

Table 1 reports the distribution of characteristics of mothers,

Comment

After adjusting for mother and infant characteristics, we found that mothers with OSA were 1.76, 2.31, 1.34, 1.74, 1.60, 1.63, and 3.18 times more likely than unaffected mothers to have LBW, preterm, SGA babies, CS, preeclampsia, gestational diabetes, and gestational hypertension, respectively.

Our findings parallel the conclusions of many prior studies.3, 7, 9, 12, 14, 15, 16, 17 For example, Sahin et al15 reported that fetuses of women with OSA had lower mean birthweights than those of women

References (27)

  • Z.F. Udwadia et al.

    Prevalence of sleep-disordered breathing and sleep apnea in middle-aged urban Indian men

    Am J Respir Crit Care Med

    (2004)
  • J.R. Stradling et al.

    Predictors and prevalence of obstructive sleep apnoea and snoring in 1001 middle aged men

    Thorax

    (1991)
  • D.I. Loube et al.

    Self-reported snoring in pregnancyAssociation with fetal outcome

    Chest

    (1996)
  • Cited by (0)

    The authors report no conflict of interest.

    Cite this article as: Chen Y-H, Kang J-H, Lin C-C, et al. Obstructive sleep apnea and the risk of adverse pregnancy outcomes. Am J Obstet Gynecol 2012;206:136.e1-5.

    View full text