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Sleep and Breathing
Erschienen in: Sleep and Breathing 2/2019

25.09.2018 | Sleep Breathing Physiology and Disorders • Review

The prevalence of obstructive sleep apnea and its association with pregnancy-related health outcomes: a systematic review and meta-analysis

verfasst von: Lina Liu, Guang Su, Shuling Wang, Bingqian Zhu

Erschienen in: Sleep and Breathing | Ausgabe 2/2019

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Abstract

Purpose

Obstructive sleep apnea (OSA) is common during pregnancy. Nevertheless, prevalence estimates of OSA have varied widely due to variabilities in the assessment methods. This meta-analysis aimed to examine the prevalence of objectively assessed OSA and its association with pregnancy-related health outcomes in pregnant women.

Methods

This review was developed following the PRISMA guideline. A systematic search was conducted in major electronic databases to identify studies conducted from inception to January 2018. The pooled estimates with 95% confidence interval were calculated using the inverse variance method. Forest plots were used to present the results of individual studies and the pooled effect sizes.

Results

Thirty-three studies were included. The mean gestational age was between 21.2 (8.5) and 37.3 (2.1) weeks. The pooled worldwide prevalence of OSA was 15% (95% CI 12–18%). The prevalence estimates ranged from 5% in the European Region to 20% in the Region of Americas. The prevalence estimates for different trimesters ranged from 15 to 19%. OSA was related to an increased risk for gestational hypertension, gestational diabetes, pre-eclampsia, C-section, postoperative wound complication, and pulmonary edema. The pooled adjusted odds ratio (aOR) values were 1.97, 1.55, 2.35, 1.42, 1.87, and 6.35, respectively. OSA was also related to an increased risk for preterm birth (aOR = 1.62) and neonatal intensive care unit admission (aOR = 1.28).

Conclusions

OSA is a common health issue in pregnant women. OSA is associated with various pregnancy-related health outcomes. Routine screening, early diagnosis, and effective treatment of OSA are recommended in pregnant women, particularly during mid and late pregnancy.
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Literatur
1.
Flemons WW, Buysse D, Redline S, Oack A, Strohl K, Wheatley J et al (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep 22:667–689CrossRef
2.
3.
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328:1230–1235CrossRefPubMed
4.
Izci B, Vennelle M, Liston WA, Dundas KC, Calder AA, Douglas NJ (2006) Sleep-disordered breathing and upper airway size in pregnancy and post-partum. Eur Respir J 27:321–327CrossRefPubMed
5.
Longworth H, McCallin K, Narayanan RP, Turner MA, Quenby S, Rycroft D, Charnley M, Abayomi J, Topping J, Weeks AD, Wilding JPH (2017) Screening methods for obstructive sleep apnoea in severely obese pregnant women. Clin Obes 7:239–244CrossRefPubMed
6.
Sharkey KM, Waters K, Millman RP, Moore R, Martin SM, Bourjeily G (2014) Validation of the Apnea Risk Evaluation System (ARES) device against laboratory polysomnography in pregnant women at risk for obstructive sleep apnea syndrome. J Clin Sleep Med 10:497–502PubMedPubMedCentral
7.
Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak CP (2003) The role of actigraphy in the study of sleep and circadian rhythms. Sleep 26:342–392CrossRefPubMed
8.
Antony KM, Agrawal A, Arndt ME, Murphy AM, Alapat PM, Guntupalli KK, Aagaard KM (2014) Association of adverse perinatal outcomes with screening measures of obstructive sleep apnea. J Perinatol 34:441–448CrossRefPubMed
9.
Olivarez SA, Ferres M, Antony K, Mattewal A, Maheshwari B, Sangi-Haghpeykar H, Aagaard-Tillery K (2011) Obstructive sleep apnea screening in pregnancy, perinatal outcomes, and impact of maternal obesity. Am J Perinatol 28:651–658CrossRefPubMed
10.
Na-Rungsri K, Lertmaharit S, Lohsoonthorn V, Totienchai S, Jaimchariyatam N (2016) Obstructive sleep apnea and the risk of preterm delivery. Sleep Breath 20:1111–1117CrossRefPubMed
11.
Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 14:540–545CrossRefPubMed
12.
Chung F, Subramanyam R, Liao P, Sasaki E, Shapiro C, Sun Y (2012) High STOP-Bang score indicates a high probability of obstructive sleep apnoea. Brit J Anaesth 108:768–775CrossRefPubMedPubMedCentral
13.
Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP (1999) Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 131:485–491CrossRefPubMed
14.
Izci B, Martin SE, Dundas KC, Liston WA, Calder AA, Douglas NJ (2005) Sleep complaints: snoring and daytime sleepiness in pregnant and pre-eclamptic women. Sleep Med 6:163–169CrossRefPubMed
15.
Chien LY, Ko YL (2004) Fatigue during pregnancy predicts caesarean deliveries. J Adv Nurs 45:487–494CrossRefPubMed
16.
Facco FL, Parker CB, Reddy UM, Silver RM, Koch MA, Louis JM, Basner RC, Chung JH, Nhan-Chang CL, Pien GW, Redline S, Grobman WA, Wing DA, Simhan HN, Haas DM, Mercer BM, Parry S, Mobley D, Hunter S, Saade GR, Schubert FP, Zee PC (2017) Association between sleep-disordered breathing and hypertensive disorders of pregnancy and gestational diabetes mellitus. Obstet Gynecol 129:31–41CrossRefPubMedPubMedCentral
17.
Bourjeily G, Danilack VA, Bublitz MH, Lipkind H, Muri J, Caldwell D, Tong I, Rosene-Montella K (2017) Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort. Sleep Med 38:50–57CrossRefPubMedPubMedCentral
18.
Chen YH, Kang JH, Lin CC, Wang IT, Keller JJ, Lin HC (2012) Obstructive sleep apnea and the risk of adverse pregnancy outcomes. Am J Obstet Gynecol 206:136. e1–136. e5CrossRef
19.
Sahin FK, Koken G, Cosar E, Saylan F, Fidan F, Yilmazer M, Unlu M (2008) Obstructive sleep apnea in pregnancy and fetal outcome. Int J Gynaecol Obstet 100:141–146CrossRefPubMed
20.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 4:1CrossRefPubMedPubMedCentral
21.
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Prisma group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med 6:e1000097CrossRefPubMedPubMedCentral
22.
Einhorn D, Stewart D, Erman M, Gordon N, Philis-Tsimikas A, Casal E (2007) Prevalence of sleep apnea in a population of adults with type 2 diabetes mellitus. Endocr Pract 13:355–362CrossRefPubMed
23.
Muxfeldt ES, Margallo VS, Guimarães GM, Salles GF (2014) Prevalence and associated factors of obstructive sleep apnea in patients with resistant hypertension. Am J Hypertens 27:1069–1078CrossRefPubMed
24.
Iber CA, Chesson AL Jr (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Westchester, American Academy of Sleep Medicine
25.
Sterne JAC, Egger M (2001) Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 54:1046–1055CrossRefPubMed
26.
Higgins J, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558CrossRefPubMed
27.
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188CrossRefPubMed
28.
Duce B, Milosavljevic J, Hukins C (2015) The 2012 AASM respiratory event criteria increase the incidence of hypopneas in an adult sleep center population. J Clin Sleep Med 11:1425–1431CrossRefPubMedPubMedCentral
29.
Bassan H, Uliel-Sibony S, Katsav S, Farber M, Tauman R (2016) Maternal sleep disordered breathing and neonatal outcome. Isr Med Assoc J 18:45–48PubMed
30.
Bin Y, Cistulli PA, Ford JB (2016) Population-based study of sleep apnea in pregnancy and maternal and infant outcomes. J Clin Sleep Med 12:871–877CrossRefPubMedPubMedCentral
31.
Bisson M, Series F, Giguere Y, Pamidi S, Kimoff J, Weisnagel SJ et al (2014) Gestational diabetes mellitus and sleep-disordered breathing. Obstet Gynecol 123:634–641CrossRefPubMed
32.
Bourjeily G, Sharkey KM, Mazer J, Moore R, Martin S, Millman R (2015) Central sleep apnea in pregnant women with sleep disordered breathing. Sleep Breath 19:835–840CrossRefPubMed
33.
Champagne K, Schwartzman K, Opatrny L, Barriga P, Morin L, Mallozzi A, Benjamin A, Kimoff RJ (2009) Obstructive sleep apnoea and its association with gestational hypertension. Eur Respir J 33:559–565CrossRefPubMed
34.
Facco F, Cici L, Andrea C, Ashley K, William G, Phyllis Z (2012) Sleep-disordered breathing: a risk factor for adverse pregnancy outcomes? Am J Perinatol 29:277–282CrossRefPubMed
35.
Felder JN, Baer RJ, Rand L, Jelliffe-Pawlowski LL, Prather AA (2017) Sleep disorder diagnosis during pregnancy and risk of preterm birth. Obstet Gynecol 130:573–581CrossRefPubMed
36.
Fung AM, Wilson DL, Lappas M, Howard M, Barnes M, O’Donoghue F, Tong S, Esdale H, Fleming G, Walker SP (2013) Effects of maternal obstructive sleep apnoea on fetal growth: a prospective cohort study. PLoS One 8:e68057CrossRefPubMedPubMedCentral
37.
Guilleminault C, Querra-Salva M, Chowdhuri S, Poyares D (2000) Normal pregnancy, daytime sleeping, snoring and blood pressure. Sleep Med 1:289–297CrossRefPubMed
38.
Lockhart EM, Ben Abdallah A, Tuuli MG, Leighton BL (2015) Obstructive sleep apnea in pregnancy: assessment of current screening tools. Obstet Gynecol 126:93–102CrossRefPubMed
39.
Louis JM, Auckley D, Sokol RJ, Mercer BM (2010) Maternal and neonatal morbidities associated with obstructive sleep apnea complicating pregnancy. Am J Obstet Gynecol 202:261.e1–261.e5CrossRef
40.
Louis J, Auckley D, Miladinovic B, Shepherd A, Mencin P, Kumar D, Mercer B, Redline S (2012) Perinatal outcomes associated with obstructive sleep apnea in obese pregnant women. Obstet Gynecol 120:1085–1092PubMed
41.
Louis JM, Mogos MF, Salemi JL, Redline S, Salihu HM (2014) Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998–2009. Sleep 37:843–849CrossRefPubMedPubMedCentral
42.
Maasilta P, Bachour A, Teramo K, Polo O, Laitinen LA (2001) Sleep-related disordered breathing during pregnancy in obese women. Chest 120:1448–1454CrossRefPubMed
43.
McIntyre JP, Ingham CM, Hutchinson BL, Thompson JM, McCowan LM, Stone PR et al (2016) A description of sleep behaviour in healthy late pregnancy, and the accuracy of self-reports. BMC Pregnancy Childbirth 16:115CrossRefPubMedPubMedCentral
44.
Miyagawa S, Emori Y, Kawano A, Sakurai S, Tanigawa T (2011) Relationship between sleep-disordered breathing and perinatal outcome in pregnant women. J Jpn Acad Midwif 25:5–12CrossRef
45.
O’Brien LM, Bullough AS, Shelgikar AV, Chames MC, Armitage R, Chervin RD (2012) Validation of Watch-PAT-200 against polysomnography during pregnancy. J Clin Sleep Med 8:287–294PubMedPubMedCentral
46.
O’Brien L, Bullough AS, Chames MC, Shelgikar AV, Armitage R, Guilleminualt C, Sullivan CE, Johnson TRB, Chervin RD (2014) Hypertension, snoring, and obstructive sleep apnoea during pregnancy: a cohort study. BJOG 121:1685–1693CrossRefPubMedPubMedCentral
47.
Olivarez SA, Maheshwari B, McCarthy M, Zacharias N, van den Veyver I, Casturi L et al (2010) Prospective trial on obstructive sleep apnea in pregnancy and fetal heart rate monitoring. Am J Obstet Gynecol 202:552.e1–552.e7CrossRef
48.
Pamidi S, Marc I, Simoneau G, Lavigne L, Olha A, Benedetti A, Sériès F, Fraser W, Audibert F, Bujold E, Gagnon R, Schwartzman K, Kimoff RJ (2016) Maternal sleep-disordered breathing and the risk of delivering small for gestational age infants: a prospective cohort study. Thorax 71:719–725CrossRefPubMed
49.
Pien GW, Pack AI, Jackson N, Maislin G, Macones GA, Schwab RJ (2013) Risk factors for sleep-disordered breathing in pregnancy. Thorax 69:371–377CrossRefPubMed
50.
Reutrakul S, Zaidi N, Wroblewski K, Kay HH, Ismail M, Ehrmann DA, van Cauter E (2013) Interactions between pregnancy, obstructive sleep apnea, and gestational diabetes mellitus. J Clin Endocrinol Metab 98:4195–4202CrossRefPubMedPubMedCentral
51.
Sarberg M, Bladh M, Josefsson A, Svanborg E (2016) Sleepiness and sleep-disordered breathing during pregnancy. Sleep Breath 20:1231–1237CrossRefPubMed
52.
Spence DL, Allen RC, Lutgendorf MA, Gary VR, Richard JD, Gonzalez SC (2017) Association of obstructive sleep apnea with adverse pregnancy-related outcomes in military hospitals. Eur J Obstet Gynecol Reprod Biol 210:166–172CrossRefPubMed
53.
Watanabe M, Shinohara H, Kodama H (2015) Impact of overnight oximetry findings on cardiac autonomic modulation in women during second trimester of uncomplicated pregnancy. J Obstet Gynaecol Res 41:689–696CrossRefPubMed
54.
Wilson DL, Walker SP, Fung AM, O’Donoghue F, Barnes M, Howard M (2013) Can we predict sleep-disordered breathing in pregnancy? The clinical utility of symptoms. J Sleep Res 22:670–678CrossRefPubMed
55.
Yin TT, Williams N, Burton C, Ong SS, Loughna P, Britton JR, Thornton JG (2008) Hypertension, fetal growth restriction and obstructive sleep apnoea in pregnancy. Eur J Obstet Gynecol Reprod Biol 141:35–38CrossRefPubMed
56.
Venkata C, Venkateshiah SB (2009) Sleep-disordered breathing during pregnancy. J Am Board Fam Med 22:158–168CrossRefPubMed
57.
Lee J, Eklund EE, Lambert-Messerlian G, Palomaki GE, Butterfield K, Curran P, Bourjeily G (2017) Serum progesterone levels in pregnant women with obstructive sleep apnea: a case-control study. J Women’s Health 26:259–265CrossRef
58.
Cai XH, Xie YP, Li XC, Qu WL, Li T, Wang HX, Lv JQ, Wang LX (2013) The prevalence and associated risk factors of sleep disorder-related symptoms in pregnant women in China. Sleep Breath 17:951–956CrossRefPubMed
59.
Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165:1217–1239CrossRefPubMed
60.
Izci-Balserak B, Pien GW (2010) Sleep-disordered breathing and pregnancy: potential mechanisms and evidence for maternal and fetal morbidity. Curr Opin Pulm Med 16:574–582CrossRefPubMedPubMedCentral
61.
Bublitz MH, Monteiro JF, Caraganis A, Martin S, Parker J, Larson L et al (2018) Obstructive sleep apnea in gestational diabetes: a pilot study of the role of the hypothalamic-pituitary-adrenal axis. J Clin Sleep Med 14(1):87–93
62.
Ding XX, Wu YL, Xu SJ, Zhang SF, Jia XM, Zhu RP, Hao JH, Tao FB (2014) A systematic review and quantitative assessment of sleep-disordered breathing during pregnancy and perinatal outcomes. Sleep Breath 18:703–713CrossRefPubMed
63.
Pamidi S, Pinto LM, Marc I, Benedetti A, Schwartzman K, Kimoff RJ (2014) Maternal sleep-disordered breathing and adverse pregnancy outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol 210:52.e1–52e14CrossRef
64.
Gozal D, Reeves SR, Row BW, Neville JJ, Guo SZ, Lipton AJ (2003) Respiratory effects of gestational intermittent hypoxia in the developing rat. Am J Respir Crit Care Med 167:1540–1547CrossRefPubMed
65.
Iqbal W, Ciriello J (2013) Effect of maternal chronic intermittent hypoxia during gestation on offspring growth in the rat. Am J Obstet Gynecol 209:564.e1–564.e9CrossRef
66.
Dickersin K (1990) The existence of publication bias and risk factors for its occurrence. JAMA 263:1385–1389CrossRefPubMed
67.
Sterne JAC, Gavaghan D, Egger M (2000) Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J Clin Epidemiol 53:1119–1129CrossRefPubMed
68.
Sutton AJ, Duval SJ, Tweedie RL, Abrams KR, Jones DR (2000) Empirical assessment of effect of publication bias on meta-analyses. BMJ 320:1574–1577CrossRefPubMedPubMedCentral
Metadaten
Titel
The prevalence of obstructive sleep apnea and its association with pregnancy-related health outcomes: a systematic review and meta-analysis
verfasst von
Lina Liu
Guang Su
Shuling Wang
Bingqian Zhu
Publikationsdatum
25.09.2018
Verlag
Springer International Publishing
Erschienen in
Sleep and Breathing / Ausgabe 2/2019
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI
https://doi.org/10.1007/s11325-018-1714-7

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