Can gestational Hypertension Be modified By Treating nocturnal airflow Limitation?

Reid, John; Taylor-Gjevre, Regina M.; Gjevre, John; Skomro, Robert; Fenton, Mark; Olatunbosun, Femi; Gordon, John; Cotton, David

doi:10.5664/jcsm.2574

Cited by 27 publications

(46 citation statements)

References 26 publications

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“…Furthermore, studies to examine the effect of CPAP treatment on pregnancy endpoints have been insufficiently powered or limited in the scope of endpoints. 66–71 The largest of these trials treated women with preeclampsia with CPAP and used improvements in fetal movement and cardiac output as primary clinical endpoints. 67,68 …”

Section: Conclusion/discussionmentioning

confidence: 99%

NuMoM2b Sleep-Disordered Breathing study: objectives and methods

Facco

Parker

Reddy

et al. 2015

American Journal of Obstetrics and Gynecology

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Objective The objective of the Sleep Disordered Breathing substudy of the Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-be (nuMoM2b) is to determine whether sleep disordered breathing during pregnancy is a risk factor for adverse pregnancy outcomes. Methods nuMoM2b is a prospective cohort study of 10,037 nulliparous women with singleton gestations, conducted across 8 sites, with a central Data Coordinating and Analysis Center. The Sleep Disordered Breathing substudy recruited 3702 women from the cohort to undergo objective, overnight in-home assessments of sleep disordered breathing. A standardized Level 3 home sleep test was performed between 60–150 weeks of pregnancy (Visit 1) and again between 220–310 weeks of pregnancy (Visit 3). Scorings of tests were conducted by a central Sleep Reading Center. Participants and their health care providers were notified if test results met “urgent referral” criteria based on threshold levels of apnea hypopnea indices, oxygen saturation levels or ECG abnormalities, but otherwise were not notified of test results. The primary pregnancy outcomes to be analyzed in relation to maternal sleep disordered breathing are preeclampsia, gestational hypertension, gestational diabetes, fetal growth restriction, and preterm birth. Results Objective data were obtained at Visit 1 on 3261 women, 88.1% of studies attempted; and at Visit 3 on 2511 women, 87.6% of studies attempted. Basic characteristics of the substudy cohort are reported in this methods paper. Conclusion The substudy is designed to address important questions regarding the relationship of sleep disordered breathing on the risk of preeclampsia and other outcomes of relevance to maternal and child health.

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Section: Conclusion/discussionmentioning

confidence: 99%

NuMoM2b Sleep-Disordered Breathing study: objectives and methods

Facco

Parker

Reddy

et al. 2015

American Journal of Obstetrics and Gynecology

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“…184 Women who experience sleep disturbances, but not specifically SDB, were likely to have an increase in inflammation in terms of IL-6 but not TNF-α, 350 whereas no improvement of inflammatory markers were seen following a single night of CPAP for mild SDB in pregnancy. 274 We were unable to confirm any adverse impact of SDB on the anti-angiogenic biomarkers of PE.…”

Section: Placental Factors -Summarymentioning

confidence: 74%

“…Yinon et al 184 reported a significant correlation between RDI and mean BP in preeclamptic women, whereas Pien et al 7 found no such association in a mostly normotensive sample. Reid et al 274 failed to demonstrate a significant improvement in BP amongst GH women following treatment of mild SDB with CPAP.…”

Section: Nocturnal Blood Pressure and Sleep-disordered Breathingmentioning

confidence: 95%

Sleep-disordered breathing in gestational hypertension and preeclampsia: impact on maternal and fetal outcomes

et al. 2019

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“…Notably, the adverse hemodynamic changes associated with sleep in women with preeclampsia can be minimized by PAP therapy [63,68]. Although Edwards et al [63] found a marked decrease in blood pressure with only one night of PAP treatment, others have failed to replicate this finding with a single night of therapy [69]. Indeed, a recent case study suggests that more than one night is required to demonstrate improvement: PAP therapy was initiated in a woman at 29 weeks gestation with early onset preeclampsia and severe OSA [70].…”

Section: Treatment Of Sdb In Pregnancymentioning

confidence: 88%

Sleep-Disordered Breathing in Pregnancy

O’Brien

2016

Curr Sleep Medicine Rep

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Sleep-disordered breathing (SDB) during pregnancy has emerged as a predictor of both maternal and fetal adverse outcomes. Data suggest that SDB during pregnancy is associated with maternal gestational hypertension and preeclampsia as well as gestational diabetes. Furthermore, there are increasing reports that SDB may play a role in fetal growth restriction, preterm birth, increased cesarean sections, and increased neonatal intensive care unit (NICU) admissions. The public health impact of unrecognized maternal SDB is therefore immense. Treatment of SDB in the general population has been shown to improve cardiovascular outcomes and daytime functioning, and although no large intervention trial has been conducted in pregnant women, small pilot studies demonstrate promising results.

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Can gestational Hypertension Be modified By Treating nocturnal airflow Limitation?

Cited by 27 publications

References 26 publications

NuMoM2b Sleep-Disordered Breathing study: objectives and methods

NuMoM2b Sleep-Disordered Breathing study: objectives and methods

Sleep-disordered breathing in gestational hypertension and preeclampsia: impact on maternal and fetal outcomes

Sleep-Disordered Breathing in Pregnancy

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