Obstructive sleep apnoea in pregnancy and its association with pre-eclampsia

Abstract

Background: Obstructive sleep apnoea (OSA) in pregnancy is associated with an increased morbidity and mortality to both mother and foetus. In the South African setting the proportion of pregnant females suffering from OSA has not been well studied; nor has the association with pre-eclampsia. This study aimed to determine the prevalence of OSA in females before 35 weeks gestation using the STOP-BANG questionnaire and to determine the association with pre-eclampsia in a local South African setting. Methods: A cross-sectional analytical study including 234 patients was conveniently sampled from Kalafong Hospital's antenatal ward, clinic and labour ward. Participants were of more than 20 weeks and less than 35 weeks gestation. All participants were interviewed with a modified STOP-BANG questionnaire. Patients were consecutively enrolled without prior knowledge of the presence of pre-eclampsia. At Kalafong hospital all pregnant patients are routinely screened and investigated for pre-eclampsia according to standard criteria. Results: The median gestational age in this sample was 28 weeks; 80.3% (CI 74.62-85.2%) of pregnant females had a low risk for OSA, 15.4% (CI 11.01-20.65%) had an intermediate risk and 3% (CI 6.47-14.58%) had a high risk for OSA. A modified STOP-BANG questionnaire had a sensitivity of 62.5% and a specificity of 82.1% for pre-eclampsia when a score of 3 and more was scored. Females at high risk of OSA had an OR of 8.4 (CI 2.88-24.6) for having pre-eclampsia. Conclusions: The authors report 15.4% of the study's pregnant population to be at intermediate risk and 3% at high risk of OSA. The association between the hypertensive disorders and OSA must be considered and screening implementation considered.

An Assessment of Risks Associated with Obstructive Sleep Apnea and Its Relationship with Adverse Health Outcomes among Pregnant Women. A Multi-Hospital Based Study

“…In the current study, 1.4% of the participants were found to have a greater risk for developing OSA which was again less than 13.4% [14], 18.4% [15], 26.4% [9], 26.7% [16] and 30.9% [17] reported in previous studies. The trimester wide distribution of greater risk status for OSA was none in the first, 1.8% in the second, and 1.4% in the third trimester among participants in this study.…”

Recognising obstructive sleep apnoea in pregnancy – a survey of UK obstetric anaesthetists

“…Obstructive sleep apnoea (OSA) in pregnancy is a risk factor for mortality and morbidity, including preeclampsia, pregnancy-induced hypertension and gestational diabetes [1][2][3]. With rising obesity rates, the incidence of OSA is likely to increase.…”

Trainee fatigue – time for a culture change? A reply

“…Effective leadership strategies are crucial to the success of delivering this [2]. Presenting the results of the survey highlights some of the issues of excessive fatigue and the next step must be to develop a management strategy to address it.…”

“…There were concerns that the inclusion of such sensitive questions might serve to deter trainees from completing the survey, although we are in complete agreement with Dr Swinkels that the correlation between medical error and tiredness is an area for future study. We believe this must occur in conjunction with introduction of measures to mitigate the risks of fatigue [2], such as Fatigue Management Systems, as discussed in the letter by Dr Noone [3].…”

“…Obstructive sleep apnoea (OSA) in pregnancy is a risk factor for mortality and morbidity, including preeclampsia, pregnancy-induced hypertension and gestational diabetes [1][2][3]. With rising obesity rates, the incidence of OSA is likely to increase.…”