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Poster session II Clinical obstetrics, diabetes, labor, medical-surgical-disease, physiology/endocrinology, prematurity: Abstracts 237 - 386| Volume 208, ISSUE 1, SUPPLEMENT , S117, January 01, 2013

256: Sleep apnea in early pregnancy: an independent risk factor for the development of gestational diabetes

      Objective

      Objective assessments of the association between sleep apnea (SA) and glucose metabolism in pregnancy are limited. The objective of this study was to evaluate the relationship between objectively assessed SA in early pregnancy and the subsequent development of gestational diabetes mellitus (GDM) in a cohort of high risk pregnant women.

      Study Design

      This was a planned subgroup analysis of data from a SA and preeclampsia study. Women with chronic hypertension, obesity, twin gestation and/or a history of preeclampsia (i.e., those at high risk of preeclampsia) who were between 6 and 20 weeks were recruited to participate in an overnight SA evaluation with a validated portable monitor. Women with pregestational diabetes were excluded. SA was defined as an apnea-hypopnea index (AHI) of ≥ 5. The diagnosis of GDM was abstracted from the medical record and confirmed by a review of oral glucose tolerance testing (OGTT) by study personnel blinded to the sleep study results. The relationship between SA and GDM was explored using univariable and multivariable analysis.

      Results

      AHI and OGTT results were available for 75 of the 80 women recruited. The mean gestational age at the sleep study was 17.1 ± 4.2 weeks. Twenty-six (35%) women had SA and 20 (25%) developed GDM. Women with SA differed from those without SA according to various demographic characteristics (Table). Women with SA were more likely to develop GDM (46.2% vs. 14.3% p=.003). After controlling for possible confounding factors including BMI, maternal age, and a history of chronic hypertension, SA remained independently and positively associated with the development of GDM (OR 3.7, 95% CI=1.1, 13.3).
      Tabled 1Demographic and clinical characteristics
      Table thumbnail grr17

      Conclusion

      Among high-risk women, SA during the first half of pregnancy is an independent risk factor for the development of GDM. Further research is needed to determine whether screening for and treatment of SA during pregnancy can lessen the frequency of GDM.