Research Studies Evaluating Sleep-Disordered Breathing Among Pregnant Women
| Author | Year | Number of Patients | Study Design/Methods | Results/Conclusions |
|---|---|---|---|---|
| Loube D et al (28) | 1996 | 350 pregnant women and 110 nonpregnant controls | Prospective, nonrandomized, questionnaire survey | Frequent snoring was reported in the pregnant women (14% vs 4%; P < .05). No increased risks of adverse fetal outcomes noted in snorers. |
| Nikkola E et al (29) | 1996 | 10 women | Cross-sectional study during the third trimester in women with multiple pregnancies | Four of 10 patients had increased respiratory resistance on PSGs at 30 to 36 weeks’ gestation. No obstructive or central sleep apneas or oxyhemoglobin desaturations were noted. |
| Maasilta P et al (30) | 2001 | 11 obese pregnant women and 11 pregnant women with normal weight | Case-control study comparing sleep-related breathing events | AHI, 4% oxygen desaturations, and snoring times were more significant in obese pregnant women compared with patients of normal weight. |
| Guilleminault C, et al (31)* | 2004 | 12 women | Prospective study evaluating tolerance, compliance, and problems associated with nasal CPAP therapy during pregnancy | All patients tolerated CPAP therapy without complications and nightly compliance rate was 6.5 hours at 6 months of gestation. Nasal CPAP significantly improved all sleep questionnaire scales. |
| Edwards N, et al (32) | 2005 | 10 pregnant women | Case-control, longitudinal study comparing severity of SDB and maternal blood pressure responses in late pregnancy to postpartum | Ten patients with OSA were treated with nasal CPAP, with withdrawal of therapy within 2 weeks after delivery. Sleep studies were repeated 3 months after delivery. There was a significant reduction in mean AHI values postnatally, along with significant improvement in arterial oxygen saturation and reduction in blood pressure. |
| Izci B, et al (33) | 2005 | 167 healthy pregnant women, 82 preeclamptic women, and 160 nonpregnant women | Cross-sectional study | Snoring and sleepiness increased in the third trimester of pregnancy, particularly in preecalmptic women. Nonpregnant women had lower mean Epworth sleepiness scores than both pregnant and preeclamptic groups (P < .001). |
| Pien GW, et al (25) | 2005 | 155 women | Prospective study evaluating symptoms of SDB over the course of pregnancy | SDB symptoms and daytime somnolence increased significantly during pregnancy. Women with high baseline body mass indices and greater increases in neck circumference during pregnancy reported higher apnea symptom scores. |
| Izci B, et al (7) | 2006 | 100 women in third trimester were compared with equal number of nonpregnant counterparts | Cross-sectional prospective study evaluating the effect of pregnancy on upper airway dimensions | All 9 measures of upper airway caliber were smaller in pregnant women, out of which 4 dimensions were statistically significant. Three of the upper airway dimensions were significantly smaller in the third trimester of pregnancy compared with postpartum. |
| Guilleminault C, et al (34)* | 2007 | 12 pregnant women with preecalmpsia risk factors | Prospective, longitudinal study evaluating early intervention of nasal CPAP therapy | Early application of CPAP therapy alleviated sleep-related breathing disturbances but was not sufficient to prevent negative pregnancy outcomes. |
| Sahin FK, et al (35) | 2008 | 35 pregnant women with self-reported symptoms of frequent snoring or apnea | Prospective, observational study assessing nonstress test changes during maternal desaturations and evaluating fetal outcomes in pregnant women with OSA | Four (11.4%) women had OSA diagnosed by PSG. Three women had fetal heart rate decelerations accompanying maternal desaturations. The neonates of women with OSA had lower mean Apgar scores and birth weights. Three neonates of women with OSA required NHCU admission where as none of the babies born to women without OSA required the NHCU. |
↵* Studies evaluating the therapy of sleep-disordered breathing.
AHI, apnea-hypopnea index; CPAP, continuous positive airwaypressure; NHCU, newborn health care unit; OSA, obstructive sleep apnea; PSG,polysomnogram; SDB; sleep-disordered breathing.