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

Presented in preliminary form at the 23rd annual meeting of the Associated Professional Sleep Societies, Seattle, WA, June 6-11, 2009.
https://doi.org/10.1016/j.ajog.2012.08.034Get rights and content

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.

Section snippets

Materials and Methods

In this prospective study, pregnant women were recruited from prenatal clinics within the University of Michigan from March 2007 through December 2010. Women were eligible if they were ≥18 years old and ≥28 weeks pregnant with a single fetus. There were no other exclusion criteria. Written informed consent was obtained to access medical records. A comparison group of nonpregnant control women was recruited from women aged 18-45 years attending routine gynecology visits. This study was approved

Results

In total, 2038 pregnant women were invited to participate; 1719 (84%) agreed to complete the surveys, 98% of whom consented to medical record access. There were no differences in maternal age, gestational age, parity, or BMI between women who did or did not participate or who did/did not consent to medical record access (data not shown). Five women were subsequently excluded because they were <28 weeks' gestation and 2 women were excluded because they were aged <18 years. In addition, 9 women

Comment

This is the first large, prospective study to demonstrate that pregnancy-onset snoring confers significant risk to maternal cardiovascular health. These novel findings strongly implicate a role not only for snoring in general but, more specifically, for pregnancy-onset snoring in both gestational hypertension and preeclampsia. Furthermore, the PAR% suggests that if snoring plays a causal role in maternal hypertension, approximately 12-19% of hypertensive disorders during pregnancy might be

Acknowledgments

We wish to thank the pregnant women who participated in this study and the medical, nursing, and clinic staff who supported this study. We are indebted to research assistants Fatema Arastu, BA, Sierra Casper, BA, Meghan Hewlett, BA, and Meredith Hall, PA-C, MD, and to Lori A. Kempf, BA, CCRP, research coordinator, for dedicated assistance with subject recruitment.

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    L.M.O. has received equipment support from Philips Respironics Inc and has served on an advisory board for GlaxoSmithKline. R.D.C. receives educational grants from Philips Respironics Inc and Fisher Paykel Inc; is named in patents owned by the University of Michigan for signal analysis diagnostic algorithms and hardware relevant to the assessment and treatment of sleep disorders; and serves on the Board of Directors of the American Academy of Sleep Medicine. The other authors report no potential conflict of interest.

    Cite this article as: O'Brien LM, Bullough AS, Owusu JT, et al. Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: prospective cohort study. Am J Obstet Gynecol 2012;207:487.e1-9.

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