The newborns of obese pregnant women suffering from obstructive sleep apnea are more likely to be admitted to the neonatal intensive care unit than those born to obese mothers without the sleep disorder, reports a study published online September 20 in the journal Obstetrics & Gynecology.
Sleep apnea, which causes repeated awakenings and pauses in breathing during the night, was also associated with higher rates of preeclampsia in the severely overweight pregnant women, the researchers found.
"Our findings show that obstructive sleep apnea can contribute to poor outcomes for both obese mothers and their babies," said the study's lead author Dr. Judette Louis, assistant professor of obstetrics and gynecology at the University of South Florida. "Its role as a risk factor for adverse pregnancy outcomes independent of obesity should be examined more closely."
Dr. Louis, who holds a joint appointment in the USF College of Public Health's Department of Community and Family Health, conducted the study while a faculty member at Case Western Reserve University's School of Medicine. A specialist in maternal-fetal medicine, she worked with researchers from Case Western Reserve, the USF Health Morsani College of Medicine's Center for Evidence-Based Medicine, and Harvard Medical School. She joined USF in April.
The researchers analyzed data for 175 obese pregnant women enrolled in a prospective observational study, which screened prenatal patients at Cleveland's MetroHealth Medical Center for sleep-related breathing disorders. The women were tested for obstructive sleep apnea using an in-home portable device at bedtime.
Perinatal and newborn outcomes for 158 live births, including indications for NICU admissions such as respiratory complications, prematurity and congenital defects, were also reviewed.
Among the study findings:
Approximately one in five women are obese when they become pregnant, meaning they have a body mass index of at least 30, according to research from the federal Centers for Disease Control and Prevention. While numerous studies have examined complications associated with obesity in pregnancy -- including high blood pressure, gestational diabetes and cesarean deliveries -- sleep apnea has been underdiagnosed and understudied in this population of women.
The study authors suggest the best way to decrease obesity-related conditions that lead to poor pregnancy outcomes, including sleep apnea, would be to treat obesity before a woman becomes pregnant, but acknowledge that "losing weight is often difficult."
Dr. Louis said the study also points to the need for better ways to screen and treat this common form of sleep-disordered breathing during pregnancy.
The study was supported by the Robert Wood Johnson Foundation Physician Faculty Scholars program, the Case Western Reserve/Cleveland Clinic CTSA, and the National Center for Research Resources, NIH.
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