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Cited by 185Obstructive Sleep Apnea ResearchPregnancy and preeclampsia studiesGestational Diabetes Research and Management

Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort

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Bourjeily, Ghada, Danilack, Valery A., Bublitz, Margaret H., Lipkind, Heather, Muri, Janet, Caldwell, Donna, Tong, Iris, Rosene-Montella, Karen·2017·Sleep Medicine
DOI 10.1016/j.sleep.2017.06.035PMC PMC5677512
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Abstract

Objective Pregnancy and the obesity epidemic impacting women of reproductive age appear to predispose women to obstructive sleep apnea (OSA) in pregnancy. The aim of this study is to examine the association between OSA and adverse maternal outcomes in a national cohort. Methods The National Perinatal Information Center in the US was used to identify women with a delivery discharge diagnosis of OSA from 2010 to 2014. We used the International Classification of Diseases, 9th Revision to classify OSA diagnosis and maternal outcomes. Results The sample consisted of 1,577,632 gravidas with a rate of OSA of 0.12% (N=1963). There was a significant association between OSA and preeclampsia (adjusted odds ratio (aOR) 2.22, 95% confidence interval (CI) 1.94–2.54), eclampsia (aOR 2.95, 1.08–8.02) and gestational diabetes (aOR 1.51, 1.34–1.72) after adjusting for a comprehensive list of covariates which includes maternal obesity. OSA status was also associated with a 2.5- to 3.5-fold increase in risk of severe complications such as cardiomyopathy, congestive heart failure and hysterectomy. Length of hospital stay was significantly longer (5.1 ± 5.6 vs 3.0 ± 3.0 days, p<0.001) and odds of an admission to an intensive care unit higher (aOR 2.74, 2.36–3.18) in women with OSA. Conclusions Compared to pregnant women without OSA, pregnant women with OSA have a significantly higher risk of pregnancy-specific complications such as gestational hypertensive conditions and gestational diabetes, and rare medical and surgical complications such as cardiomyopathy, pulmonary edema, congestive heart failure and hysterectomy. OSA diagnosis was also associated with a longer hospital stay and significantly increased odds for admission to the intensive care unit.

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  • Other studies have found increased risks for severe maternal morbidity including eclampsia, cardiomyopathy, pulmonary embolism, and in-hospital mortality.

    “Other studies have found increased risks for severe maternal morbidity including eclampsia, cardiomyopathy, pulmonary embolism, and in-hospital mortality.1008,1009”

    From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [1008]

    The Results (page not supplied) report increased risks of eclampsia and cardiomyopathy among pregnant women with OSA. The Discussion says that, unlike this cohort, Louis et al. found a significantly higher risk of pulmonary embolism; the paper does not report increased in-hospital maternal mortality. (LLM, conf=0.87)

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Authors
Bourjeily, G., Danilack, V. A., Bublitz, M. H., Lipkind, H., Muri, J., Caldwell, D., Tong, I., & Rosene-Montella, K.
Affiliations
  • Brown University (US)
  • Yale University (US)
  • National Perinatal Information Center (US)
Corresponding author
Bourjeily, Ghada
ORCID
Venue
Sleep Medicine
Publisher
Elsevier BV
Published
2017-10
Volume
38
Pages
50-57
ISSN
1389-9457 (ISSN-L)
DOI
10.1016/j.sleep.2017.06.035
PMC
PMC5677512
OpenAlex
W2737467089
Semantic Scholar
8ab8dc7efe4dbcde565c7a053f538d92af797c99
Cited by
185
References
39
Citations by year
2026: 10 · 2025: 20 · 2024: 18 · 2023: 20 · 2022: 25 · 2021: 28 · 2020: 29 · 2019: 20 · 2018: 14 · 2017: 1
FWCI
12.95
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Sleep Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (R01HD078515, R01HL130702)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Keywords
obstructive sleep apnea, pregnancy, adverse maternal outcomes, preeclampsia, eclampsia, gestational diabetes mellitus, maternal obesity, cardiomyopathy, congestive heart failure, hysterectomy, pulmonary edema, length of hospital stay, intensive care unit admission
MeSH terms
Adult, Critical Care, Female, Humans, Length of Stay, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Risk Factors, United States, Comorbidity, Prevalence, Sleep Apnea, Obstructive

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