ResearchObstetricsMaternal sleep-disordered breathing and adverse pregnancy outcomes: a systematic review and metaanalysis
Section snippets
Objective
Our objective was to conduct a systematic review and, where feasible, metaanalysis to evaluate whether pregnant women with SDB have a higher risk of adverse pregnancy outcomes, which we defined as gestational hypertension/preeclampsia, gestational diabetes, or the delivery of low-birthweight infants, compared with pregnant women without SDB.
Methods for Review
We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement7 as the template for reporting the review.
General characteristics of included studies
Using our search strategy for electronic databases and manual citation searches, we identified and screened 4386 citations. Figure 1 outlines the selection process for the final 31 studies included in the qualitative analysis. Characteristics of the 31 studies are summarized in Table 1. Twenty-nine of these studies were observational in design3, 4, 5, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42 and the remaining 243, 44 were small-scale
Summary of findings
A systematic review of the literature investigating the association between adverse pregnancy outcomes (ie, gestational hypertension/preeclampsia, gestational diabetes, and/or delivery of low-birthweight infants) and maternal SDB yielded 21 studies that presented effect estimates, all of which were observational in design. Studies that met criteria for the metaanalysis demonstrated an increased risk of gestational hypertension/preeclampsia and gestational diabetes in pregnant women with SDB
References (50)
- et al.
Snoring, pregnancy-induced hypertension, and growth retardation of the fetus
Chest
(2000) Sleep-disordered breathing and pregnancy
Semin Perinatol
(2011)- et al.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies
Lancet
(2007) - et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
Increased plasma levels of inflammatory markers and upper airway resistance during sleep in pre-eclampsia
Sleep Med
(2008) - et al.
Le syndrome d'apnees du sommeil pendant la grossesse: prevalence des symptomes cliniques et correlation avec la pathologie vasculaire gravidique
Rev Med Interne
(2006) - et al.
Obstructive sleep apnea and the risk of adverse pregnancy outcomes
Am J Obstet Gynecol
(2012) - et al.
Self-reported short sleep duration and frequent snoring in pregnancy: impact on glucose metabolism
Am J Obstet Gynecol
(2010) - et al.
The Berlin Questionnaire for assessment of sleep disordered breathing risk in parturients and non-pregnant women
Int J Obstet Anesth
(2011) - et al.
Sleep complaints: snoring and daytime sleepiness in pregnant and pre-eclamptic women
Sleep Med
(2005)
Prevalence des symptomes cliniques du syndrome d'apnees du sommeil pendant la grossesse
Med Sommeil
Maternal and neonatal morbidities associated with obstructive sleep apnea complicating pregnancy
Am J Obstet Gynecol
Prospective trial on obstructive sleep apnea in pregnancy and fetal heart rate monitoring
Am J Obstet Gynecol
Obstructive sleep apnea in pregnancy and fetal outcome
Int J Gynecol Obstet
Maternal snoring during pregnancy is associated with enhanced fetal erythropoiesis—a preliminary study
Sleep Med
Hypertension, fetal growth restriction and obstructive sleep apnoea in pregnancy
Eur Obstet Gynecol Reprod Biol
Pre-eclampsia and nasal CPAP: part 2. Hypertension during pregnancy, chronic snoring, and early nasal CPAP intervention
Sleep Med
Clinical features and evaluation of obstructive sleep apnea-hypopnea syndrome and the upper airway resistance syndrome
Changes in symptoms of sleep-disordered breathing during pregnancy
Sleep
Pregnancy and fetal outcomes of symptoms of sleep-disordered breathing
Eur Respir J
Self-reported snoring in pregnancy: association with fetal outcome
Chest
Sleep-disordered breathing and pregnancy: potential mechanisms and evidence for maternal and fetal morbidity
Curr Opin Pulm Med
The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration
Ann Intern Med
Sleep-disordered breathing and pregnancy: potential mechanisms and evidence for maternal and fetal morbidity
Curr Opin Pulmon Med
Clinical chest medicine. Pulmonary disease and pregnancy. Preface
Clin Chest Med
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The authors report no conflict of interest.
Cite this article as: Pamidi S, Pinto LM, Marc I, et al. Maternal sleep-disordered breathing and adverse pregnancy outcomes: a systematic review and metaanalysis. Am J Obstet Gynecol 2014;210:52.e1-14.