Advertisement
Poster session II Diabetes, labor, medical-surgical-disease, obstetric quality & safety, prematurity, ultrasound-imaging: Abstracts 237 – 386| Volume 206, ISSUE 1, SUPPLEMENT , S153, January 01, 2012

324: Longitudinal study of sleep disordered breathing (SDB) in pregnancy

      Objective

      Evaluate SDB in the 2nd and 3rd trimesters (TM) using the validated Berlin Questionnaire (BQ) and assess maternal characteristics potentially predictive of SDB.

      Study Design

      Healthy women with normal pregnancies, entering obstetric care Jan, 2010 - Jan, 2011 were recruited to undergo SDB risk assessment. The BQ has 3 sections: (1) snoring severity, (2) fatigue severity and (3) chronic hypertension or a BMI>30 kg/m2. High risk for SDB is present if at least 2 of 3 sections are scored abnormal. Assessments were made in the early 2nd and 3rd TMs. Potential predictors for SDB, included age, parity, race/ethnicity, neck circumference, BMI, weight gain, gestational diabetes, Mallampati tongue position score (0-4) and Friedman tonsil size score (1-4).

      Results

      Of 499 consenting women the mean age was 23 y, 53% were multiparous, 81% were African American, and the mean BMI was 29 kg/m2. Their initial evaluation was at a mean (SD) gestational age (GA) of 15.7 (4.3) wks, and 463 (93%) returned at a mean GA of 30.0 (1.0) wks. Initial neck circumference (mean=13.4), tonsil size score (mean=1.25) and Mallampati score (mean=2.57) did not change significantly between the 2nd and 3rd TMs. The overall prevalence of high risk for SDB in the 2nd TM was 34%, which increased to 40% in the 3rd TM. In univariate analyses, multiparity, BMI, age, and neck circumference were all significant predictors of 2nd TM high-risk BQ; multiparity, BMI, age, neck circumference, tonsil size and Mallampati score were significant predictors of 3rd TM high-risk BQ. However, in multivariable analyses, only BMI (p<0.0001) and multiparity (p=0.03) significantly predicted the 2nd TM high-risk BQ, while BMI (p<0.0001) was the sole independent predictor of the 3rd TM high-risk BQ.

      Conclusion

      High-risk for SDB is common in an obstetric population with a mean BMI of 29 kg/m2 and increases over gestation. Of the predictors assessed, BMI had by the far the strongest association. In multivariable analyses, controlling for BMI, and parity, other predictors for SDB, were not significantly associated with a high-risk BQ.