PURPOSE: Snoring is associated with adverse pregnancy outcomes including gestational hypertensive disorders, gestational diabetes and cesarean deliveries. The purpose of this study was to assess whether excessive daytime sleepiness assessed by Epworth Sleepiness Scale (ESS) increases the risk of these complications further.
METHODS: Following IRB approval and informed consent, english-speaking women in the immediate postpartum period were systematically selected and recruited. Women answered a survey that includes questions regarding symptoms of sleep disordered breathing using the multivariable apnea prediction index, and excessive daytime sleepiness using ESS. Pregnancy and fetal outcomes were collected by review of medical records. ESS > 10 was used as a cut off (sleepy group). Standard statistical analysis with multivariable logistic regression was performed.
RESULTS: A total of 939 women were recruited in 18 months. Mean age was 29.1 +/- 6.0 years. The majority of women were white, non-Hispanic (69.3%). Mean BMI pre-pregnancy was 26.1 +/- 6.2 and 22% of women had BMI >/= 30. Snoring women who underwent cesarean delivery were more likely to have higher ESS scores, OR 1.08 (1.01-1.15) even after adjusting for birth weight and multifetal pregnancies. Snorers with gestational diabetes tended to have higher ESS scores, OR 1.07 (0.99-1.14), p=0.09. There was no statistically significant difference in gestational hypertension, gestational age at birth or birth weight among sleepy snorers and non sleepy snorers.
CONCLUSIONS: Higher ESS scores appear to add to the association of snoring with cesarean delivery. However, abnormal ESS scores did not add to the risk of gestational hypertension, gestational diabetes, preterm birth or growth restriction
CLINICAL IMPLICATIONS: Excessive daytime sleepiness may have some prognostic implications in pregnant women who snore.
DISCLOSURE: Ghada Bourjeily: Grant monies (from sources other than industry): unrestricted
The following authors have nothing to disclose: Peter Sawan, Rana El Sabbagh, Christina Raker
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