Prospective trial on obstructive sleep apnea in pregnancy and fetal heart rate monitoring
Received 24 June 2009; received in revised form 20 September 2009; accepted 7 December 2009. published online 22 February 2010.
Objective
Obstructive sleep apnea (OSA) involves episodic nocturnal apneas. Using polysomnography, we examined the predictive capacity of screening questionnaires (Berlin) in pregnancy. Incorporating simultaneous fetal heart rate monitoring (FHM), we examined the association of maternal apnea with FHM abnormalities.
Study Design
We enrolled 100 pregnant women at 26-39 weeks of gestation with OSA screening and baseline data ascertainment who underwent polysomnography and FHM for ≥3 hours. The relationship between maternal characteristics, OSA, and FHM was explored with multivariate analyses that were controlled for potential confounders.
Results
When compared with polysomnography, sensitivity and specificity by Berlin screening was 35% and 63.8%, respectively; the snoring component of the Berlin correlated better with oxygen desaturation <95% (P = .003). Body mass index was a significant confounder (rs = 0.44; P < .0001). No association was observed between FHM abnormalities and OSA parameters.
Conclusion
In pregnancy, the Berlin questionnaire poorly predicts OSA. It is unclear whether fetal compromise during maternal apnea is a mechanism in OSA that is related to pregnancy outcome.
aDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Ben Taub General Hospital, Houston, TX
bDepartment of Pulmonary-Critical Care, Baylor College of Medicine and Ben Taub General Hospital, Houston, TX
Reprints: Kjersti M. Aagaard-Tillery, MD, PhD, Baylor College of Medicine, 1 Baylor Plaza, Jones 314, Houston, TX 77030
Authorship and contribution to the article is limited to the 8 authors indicated. There was no outside funding or technical assistance with the production of this article.
Cite this article as: Olivarez SA, Maheshwari B, McCarthy M, et al. Prospective trial on obstructive sleep apnea in pregnancy and fetal heart rate monitoring. Am J Obstet Gynecol 2010;202:552.e1-7.
ABSTRACT