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Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: prospective cohort study

Published:September 10, 2012DOI:https://doi.org/10.1016/j.ajog.2012.08.034

      Objective

      This study aimed to prospectively examine the impact of chronic vs pregnancy-onset habitual snoring on gestational hypertension, preeclampsia, and gestational diabetes.

      Study Design

      Third-trimester pregnant women were recruited from a large, tertiary medical center from March 2007 through December 2010 and screened for the presence and duration of habitual snoring, as a known marker for sleep-disordered breathing. Clinical diagnoses of gestational hypertension, preeclampsia, and gestational diabetes were obtained.

      Results

      Of 1719 pregnant women, 34% reported snoring, with 25% reporting pregnancy-onset snoring. After adjusting for confounders, pregnancy-onset, but not chronic, snoring was independently associated with gestational hypertension (odds ratio, 2.36; 95% confidence interval, 1.48–3.77; P < .001) and preeclampsia (odds ratio, 1.59; 95% confidence interval, 1.06–2.37; P = .024) but not gestational diabetes.

      Conclusion

      New-onset snoring during pregnancy is a strong risk factor for gestational hypertension and preeclampsia. In view of the significant morbidity and health care costs associated with hypertensive diseases of pregnancy, simple screening of pregnant women may have clinical utility.

      Key words

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      Linked Article

      • Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: prospective cohort study
        American Journal of Obstetrics & GynecologyVol. 208Issue 6
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          I commend O'Brien et al1 for drawing attention to a potentially dangerous yet overlooked clinical condition in pregnancy in the article entitled, “Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: prospective cohort study.” Particularly interesting is the observation that pregnancy-onset habitual snoring or what I term “gestational obstructive sleep apnea (OSA)” may be more problematic then superimposed OSA. The opportunity for intervention trials to determine a treatment effect on pregnancy-induced hypertension and preeclampsia is evident; however, the results of such trials should not cloud the fact that, once the patient with snoring is diagnosed definitively with clinically significant OSA, she should be treated effectively.
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