Sleep apnea screening: An overlooked aspect of routine prenatal care.
Saeed H, Chauhan G, Daklallah Y, Attali A, Swain M, and Sangha R. Sleep apnea screening: An overlooked aspect of routine prenatal care. Obstet Gynecol 2018; 131:50S.
Introduction: Obstructive sleep apnea (OSA) in pregnancy can lead to adverse maternal and neonatal outcomes such as pre-eclampsia, intrauterine growth restriction (IUGR), gestational diabetes (GDMA) and preterm birth. Polysomnography screening is "gold standard" for OSA but can be logistically challenging and not cost-effective. In this study, we will investigate simple screening tools such as the Berlin (BQ) and STOP-BANG questionnaires (SBQ) for OSA in pregnancy. Methods: We screened 169 pregnant women using the BQ and SBQ in the third trimester. A chart review was performed for primary outcomes: pre-eclampsia, IUGR and GDMA. Secondary outcomes were gestational age at time of delivery, Apgars, and birth weight. Demographics such as age, race, BMI, gravidity and smoking history were also reviewed. Results: Of the 169 women who participated in the study, 58 women(34.3%) were screened as high risk on the SBQ. Of these, 34.5% were subsequently diagnosed with pre-eclampsia(p5,0.01), 22.4% with GDMA(p=0.098), and 8.6% with IUGR(p=0.743). Of the 80 women(47.3%) who screened high risk on the BQ, 30% were diagnosed with pre-eclampsia(p5,0.01), 21.3% with GDMA(p5,0.01) and 7.5% with IUGR(p=0.929). Rate of preterm births were significantly higher in both BSQ and BQ high risk group at 29.3% and 26.3%, respectively(p5,0.01). No significant difference was noted in demographics. Conclusion: Obstructive sleep apnea is a modifiable risk factor that can be screened at time of first prenatal care visit, using the STOPBANG and Berlin questionnaires. Identifying and treating those with OSA early in pregnancy may lead to a decreased risk of pre-eclampsia, gestational diabetes and subsequent preterm deliveries.