The Impact of Sleep-Disordered Breathing on Severity of Pregnancy-Induced Hypertension and Feto-Maternal Outcomes

• Published in: Journal of obstetrics and gynaecology of India Vol. 69; no. Suppl 2; pp. 111 - 121
• Main Authors: Suri, Jyotsna, Suri, Jagdish Chander, Arora, Renu, Gupta, Megha, Adhikari, Tulsi
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.10.2019
• Subjects: Gynecology; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Original; Original Article; New-onset pregnancy hypertension; Poor fetal outcomes; Poor maternal outcomes; Preeclampsia; Gestational hypertension; Sleep-disordered breathing
• ISSN: 0971-9202; 0975-6434
• DOI: 10.1007/s13224-018-1134-4

Background There is a close association between sleep-disordered breathing (SDB) and preeclampsia. Both conditions have poor pregnancy outcomes. Methods Forty women with new-onset hypertension of pregnancy and 60 age-matched normotensive pregnant women were subjected to polysomnography. The maternal and fetal outcomes of all the subjects were noted. Results SDB occurs more frequently ( p  = 0.018; OR 13.1) and with more severity ( p 0.001; OR 1.8) in women with hypertensive disorders of pregnancy even after controlling for pre-pregnancy body mass index (BMI). Furthermore, the BMI significantly correlated with both the Apnea–Hypopnea Index (AHI; r  = 0.745; p  < 0.001) and the blood pressure ( r  = 0.617; p  < 0.001) highlighting the contribution of obesity in the causation of hypertension and SDB. We also found a significant correlation between AHI and blood pressure even after adjustment for BMI pointing toward an independent role of SDB in the development of hypertension ( r  = 0.612; p  = 0.01). Maternal and fetal complications significantly correlated with different parameters of SDB–AHI, Arousal Index and minimum oxygen saturation, in the cases and with the fetal complications in the controls as well. Conclusion SDB occurs more frequently and with more severity in women with pregnancy-induced hypertension and is associated with more severe preeclampsia and adverse feto-maternal outcomes.