Maternal sleep-disordered breathing and the risk of delivering small for gestational age infants: a prospective cohort study

Pamidi, Sushmita; Marc, Isabelle; Simoneau, Gabrielle; Lavigne, L.; Olha, A.; Benedetti, Andrea; Sériès, Frédéric; Fraser, William D.; Audibert, François; Bujold, Emmanuel; Gagnon, Robert; Schwartzman, Kevin; Kimoff, R. John

doi:10.1136/thoraxjnl-2015-208038

Cited by 75 publications

(74 citation statements)

References 42 publications

(49 reference statements)

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“…11,12 The 3D-Study recruited 2,366 women in their first trimester of pregnancy and their respective births across nine sites in the province of Quebec and gathered extensive data on the mother-father-child triad from conception until 2 years postpartum. At 2 years postpartum, children underwent cognitive, motor, and language testing using the Bayley Scales of Infant and Toddler Development, 3rd edition, and the MacArthur-Bates Communicative Development Our primary objective was to compare the neurodevelopment in children born with the help of fertility treatments (exposed) relative to those born off pregnancies conceived naturally (controls).…”

Section: Methodsmentioning

confidence: 99%

Neurodevelopmental Outcomes After Assisted Reproductive Technologies

Balayla

Sheehy

Fraser

et al. 2017

Obstetrics &Amp; Gynecology

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OBJECTIVE-To compare children's cognitive, motor, and language development at 2 years of age after assisted reproductive technologies (ARTs) relative to natural conception. 3D-Study (20103D-Study ( -2012) is a prospective cohort study, which sought to improve the understanding among perinatal events, obstetric outcomes, and child development. A total of 2,366 pregnant women were recruited, of whom 278 conceived with ART: ovarian stimulation, intrauterine sperm insemination, in vitro fertilization, intracytoplasmic sperm injection, or in vitro maturation. Natural conception was defined as the unassisted establishment of pregnancy. Cognitive, motor, and language neurodevelopmental outcomes were compared between ART and natural conception groups at 24 months using the Bayley Scales of Infant and Toddler Development, 3rd edition, and the MacArthur-Bates Communicative Development Inventories. Adjusted linear regression models evaluated the effect of ART on neurodevelopmental outcomes using natural conception as a reference. CONCLUSION-Children born after ART had similar cognitive, motor, and language development as children born after natural conception at 2 years of age. These findings may be useful in the clinical counseling of patients undergoing ART. METHODS-TheTechnologic advances and changing social paradigms have led to the increased use of assisted reproductive technologies (ARTs) for the purposes of procreation. 1 The main techniques to treat infertility include: ovarian stimulation and intrauterine sperm insemination as well as techniques whereby oocytes and sperm are handled in vitro, like in vitro fertilization (IVF), intracytoplasmic sperm injection, and in vitro maturation. [2][3][4] We refer to ART as any of the aforementioned infertility treatments leading to conception outside natural coitus.In Canada, reports indicate that the use of fertility treatments increased by 50% over the past decade. 1,5 Although the short-term perinatal outcomes after ART are well established, longterm neurodevelopmental outcomes, including cognitive, motor, and language development, are still a source of controversy. 3,[6][7][8][9] A review from the National Institutes of Health recognized that "lingering data gaps [exist] in the equivocal literature for many neurodevelopmental disabilities relative to ART" and that "…cohorts with longitudinal assessment…of neurodevelopment…are paramount for the development of empirically-based guidance…." 10 Similarly, the largest systematic review of more than 80 studies addressing long-term neurodevelopment after ART concluded that additional data were required to determine the true effect of fertility treatments on these outcomes. 3In our study, we tested the hypothesis that neurodevelopment at 2 years is related to mode of conception. As such, using standardized and validated tools, the objective of this study was to compare children's cognitive, motor, and language development at 2 years of age after ART relative to natural conception. MATERIALS AND METHODSWe analyzed data...

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Section: Methodsmentioning

confidence: 99%

Neurodevelopmental Outcomes After Assisted Reproductive Technologies

Balayla

Sheehy

Fraser

et al. 2017

Obstetrics &Amp; Gynecology

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“…Similar to many symptom-based studies, several studies using objective measures of OSA have failed to find evidence of a link with PTB [23,48,49] although one study did find an increase in PTB (<37 weeks gestation and <32 weeks gestation) in women with OSA in a retrospective cohort [26]. Mean gestational age in women with OSA may be slightly shorter than controls 44 although a recent study has not been able to support these findings [47].…”

Section: Preterm Birthmentioning

confidence: 76%

“…Most studies that have longitudinally recruited women fail to find a relationship between maternal OSA and birth weight [46,47], SGA [46][47][48][49], or LGA [48]. Different polysomnographic systems were used across these studies and definitions of OSA varied by study.…”

Section: Sdb and Delivery Outcomesmentioning

confidence: 99%

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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“…Several recent studies indicate that snoring mothers are more likely to have SGA infants and exhibit higher risk for perinatal complications [88][89][90][91][92] . Furthermore, and as a validity preamble to the putative distal yet adverse role of OSA on the overall well-being of the offspring, we have shown that implementation and cholesterol levels were all significantly higher in gestationally-exposed male offspring at 24 weeks of age (corresponding to mid adulthood in human) but not in exposed female offspring 98,99 .…”

Section: Obstructive Sleep Apnoea During Pregnancy and Consequences Tmentioning

confidence: 99%

Sleep Apnoea and Early Antecedents of Adult Disease

Gozal¹

2018

BRN

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Obstructive sleep apnoea (OSA) is a highly prevalent disorder across the life spectrum including early childhood and pregnancy. Occurrence of sleep perturbations and intermittent hypoxia that constitute major hallmarks of OSA during these favourable developmental plasticity windows may facilitate emergence of incremental risks for a variety of ageing-related disorders via a multitude of epigenetic mechanisms. In addition, OSA during late adolescence and adulthood is not immune to epigenetic changes, the latter potentially playing a role in the reversibility of OSA-associated morbidities upon implementation of therapy. Furthermore, unique epigenetic signatures may provide powerful biomarkers for precision-based medicine approaches in the framework of OSA. Taken together, the conceptual umbrellas assigning major roles to epigenetics in the context of OSA-associated phenotypic expression and longitudinal disease risk trajectories is not a farfetched idea any longer. Early adoption of these biologically relevant principles and their implementation to the upcoming future clinical trials appears inevitable if progress is to occur. (BRN Rev. 2018;4(3):185-99)

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Maternal sleep-disordered breathing and the risk of delivering small for gestational age infants: a prospective cohort study

Abstract: Objectively measured SDB in the third trimester is significantly associated with the delivery of SGA infants.

Cited by 75 publications

References 42 publications

Neurodevelopmental Outcomes After Assisted Reproductive Technologies

Neurodevelopmental Outcomes After Assisted Reproductive Technologies

Sleep-Disordered Breathing in Pregnancy

Sleep Apnoea and Early Antecedents of Adult Disease

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