Pregnancy Risk: How OSA Can Affect Pregnancy

Pregnant women with obstructive sleep apnea face a higher risk of pregnancy complications, according to a study performed by Brown University.

Obstructive sleep apnea is a chronic health condition that affects 22 million Americans, according to the American Sleep Apnea Association. OSA occurs when an individual’s airway becomes blocked during sleep and the muscles of the throat relax and collapse. When the airway becomes blocked, patients gasp for air and are often startled awake.

OSA patients often experience sleep interruptions between 30 and 100 times in an eight-hour period.

Individuals with OSA frequently experience extreme fatigue, depression and moodiness. OSA has also been determined to be a contributing factor to high blood pressure, stroke, obesity and various metabolic disorders.

What Are the Dangers of Obstructive Sleep Apnea for Pregnant Women?

Study leaders found that pregnant women with OSA had a staggering 122 percent higher chance of developing pre-eclampsia, a condition that causes high blood pressure in pregnant women. Pre-eclampsia can also lead to organ failure and preterm delivery.

Babies born early frequently face many life-altering health challenges as a result of their early birth. These challenges include cardiovascular, pulmonary and neurological conditions. Preterm babies are also at risk of being developmentally delayed, developing diabetes and becoming obese.

"Pre-eclampsia affects 5 to 10 percent of pregnant women," said Dr. Mona Alqulali, M.D., Ph.D., F.A.C.O.G.

Alquali is an OBGYN practicing in the Eastern Iowa cities of Clinton and Bettendorf.

If left untreated, pre-eclampsia can develop into the more severe condition, eclampsia, which can lead to seizures during and after pregnancy.

The Rhode Island researchers also found that pregnant women with OSA had a 52 percent higher risk of developing gestational diabetes than women without the condition.

The study evaluated the medical records of over 1.5 million women across the United States who had given birth between 2010 and 2014. Of this group, 0.12 percent had been medically diagnosed with OSA.

Data gathered through this review were adjusted for factors known to contribute to OSA, like smoking and obesity.

The analysis of the information also showed that patients with OSA had longer hospital stays than their counterparts, staying on average five days after delivery versus three.

Pregnant women with OSA also faced a 174 percent greater risk of being admitted to the intensive care unit than pregnant women without OSA.

Other notable complications found in the records under review included hysterectomy, congestive heart failure and cardiomyopathy, a condition that weakens the heart muscle.

Treating Pregnant Patients for Obstructive Sleep Apnea

The first step in treating OSA is being aware of the signs of the condition. Many OSA patients report feeling fatigued, moody or irritable. Some individuals report dry mouth or dry throat, and the most telltale sign of the condition is loud snoring or gasping throughout the night.

"Treating pregnant patients for OSA is important to lower the risk of complications during and after pregnancy," Alqulali said.

The Brown researchers agree that early intervention is critical for pregnant women with the condition. Treatments for OSA include the use of the continuous positive airway pressure, or CPAP, machine; surgical removal of the tonsils, adenoids or uvula; and the use of dental orthotics.

Using these therapies will reduce episodes of OSA. When occurrences of OSA are reduced, blood pressure goes down and the risk of other complications is reduced. Patients also feel more rested, which is extremely important for expectant mothers, Alqulali said.

"Pregnant women absolutely need rest and good sleep," she said.

Early intervention does not just benefit the mother, but also the child. Lowering the risk of stress on the body caused by OSA reduces the amount of stress on the baby in utero and increases the odds of a healthy delivery.

The study was the first to link OSA with pregnancy complications.

 

Sources:

American Sleep Apnea Association. Sleep Apnea Information for Clinicians. American Sleep Apnea Association. 2017.

Sleep Review. Sleep Apnea May Increase Pregnancy Complications Risk. Sleep Review. 23 May 2017.

 

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