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- Title
Sleep-disordered Breathing in Pregnancy and after Delivery: Associations with Cardiometabolic Health.
- Authors
Facco, Francesca L.; Redline, Susan; Hunter, Shannon M.; Zee, Phyllis C.; Grobman, William A.; Silver, Robert M.; Louis, Judette M.; Pien, Grace W.; Mercer, Brian; Chung, Judith H.; Merz, C. Noel Bairey; Haas, David M.; Chia-Ling Nhan-Chang; Simhan, Hyagriv N.; Schubert, Frank P.; Parry, Samuel; Reddy, Uma; Saade, George R.; Hoffman, Matthew K.; Levine, Lisa D.
- Abstract
Rationale: Knowledge gaps exist regarding health implications of sleep-disordered breathing (SDB) identified in pregnancy and/or after delivery. Objectives: To determine whether SDB in pregnancy and/or after delivery is associated with hypertension (HTN) and metabolic syndrome (MS). Methods: nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be Heart Health Study) (N = 4,508) followed participants initially recruited during their first pregnancy. Participants returned for a visit 2-7 years after pregnancy. This study examined a subgroup who underwent SDB assessments during their first pregnancy (n = 1,964) and a repeat SDB assessment after delivery (n = 1,222). Two SDB definitions were considered: 1) apnea-hypopnea index (AHI) ⩾ 5 and 2) oxygen desaturation index (ODI) ⩾ 5. Associations between SDB and incident HTN and MS were evaluated with adjusted risk ratios (aRRs). Measurements and Main Results: The aRR for MS given an AHI ⩾ 5 during pregnancy was 1.44 (95% confidence interval [CI], 1.08-1.93), but no association with HTN was found. ODI ⩾ 5 in pregnancy was associated with both an increased risk for HTN (aRR, 2.02; 95% CI, 1.30-3.14) and MS (aRR, 1.53; 95% CI, 1.19-1.97). Participants with an AHI ⩾ 5 in pregnancy that persisted after delivery were at higher risk for both HTN (aRR, 3.77; 95% CI, 1.84-7.73) and MS (aRR, 2.46; 95% CI, 1.59-3.76). Similar associations were observed for persistent ODI ⩾ 5 after delivery. Conclusions: An AHI ⩾ 5 in pregnancy was associated with an increased risk of MS. An ODI ⩾ 5 in pregnancy was significantly associated with both HTN and MS. Participants with persistent elevations in AHI and ODI during pregnancy and at 2-7 years after delivery were at the highest risk for HTN and MS. Clinical trial registered with www.clinicaltrials.gov (NCT02231398).
- Subjects
OXYGEN; CARDIOVASCULAR diseases; POLYSOMNOGRAPHY; SLEEP apnea syndromes; RESEARCH funding; ODDS ratio; DISEASE complications
- Publication
American Journal of Respiratory & Critical Care Medicine, 2022, Vol 205, Issue 10, p1202
- ISSN
1073-449X
- Publication type
journal article
- DOI
10.1164/rccm.202104-0971OC