Association between Sleep Disordered Breathing and Neonatal Outcomes in Nulliparous Individuals

Arlin Delgado; Anthony M. Kendle; Tara Randis; Keyur Donda; Jason L. Salemi; Francesca L. Facco; Corette B. Parker; Uma M. Reddy; Robert M. Silver; Robert C. Basner; Judith H. Chung; Frank P. Schubert; Grace W. Pien; Susan Redline; Samuel Parry; William A. Grobman; Phyllis C. Zee; Judette M. Louis

doi:10.1055/a-2115-0147

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2024; 41(S 01): e2418-e2426
DOI: 10.1055/a-2115-0147

Original Article

Association between Sleep Disordered Breathing and Neonatal Outcomes in Nulliparous Individuals

Arlin Delgado

¹Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida

,

Anthony M. Kendle

¹Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida

,

Tara Randis

²Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa Florida

,

Keyur Donda

²Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa Florida

,

Jason L. Salemi

³College of Public Health, University of South Florida, Tampa, Florida

,

Francesca L. Facco

⁴Department of Obstetrics and Gynecology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

,

Corette B. Parker

⁵RTI International, Research Triangle Park, North Carolina

,

Uma M. Reddy

⁶Department of Obstetrics and Gynecology, Columbia University, New York City, New York

,

Robert M. Silver

⁷Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah

,

Robert C. Basner

⁶Department of Obstetrics and Gynecology, Columbia University, New York City, New York

,

Judith H. Chung

⁸Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, School of Medicine, Irvine, California

,

Frank P. Schubert

⁹Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, Indiana

,

Grace W. Pien

¹⁰Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland

,

Susan Redline

¹¹Departments of Medicine and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

,

Samuel Parry

¹²Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

,

William A. Grobman

¹³Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio

,

Phyllis C. Zee

¹⁴Department of Neurology and Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois

,

Judette M. Louis

¹Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida

³College of Public Health, University of South Florida, Tampa, Florida

› Institutsangaben

Abstract

Objective Our objective was to determine whether objectively measured sleep-disordered breathing (SDB) during pregnancy is associated with an increased risk of adverse neonatal outcomes in a cohort of nulliparous individuals.

Study Design Secondary analysis of the nuMom2b sleep disordered breathing substudy was performed. Individuals underwent in-home sleep studies for SDB assessment in early (6–15 weeks' gestation) and mid-pregnancy (22–31 weeks' gestation). SDB was defined as an apnea-hypopnea index ≥5 events/h at either time point. The primary outcome was a composite outcome of respiratory distress syndrome, transient tachypnea of the newborn, or receipt of respiratory support, treated hyperbilirubinemia or hypoglycemia, large-for-gestational age, seizures treated with medications or confirmed by electroencephalography, confirmed sepsis, or neonatal death. Individuals were categorized into (1) early pregnancy SDB (6–15 weeks' gestation), (2) new onset mid-pregnancy SDB (22–31 weeks' gestation), and (3) no SDB. Log-binomial regression was used to calculate adjusted risk ratios (RR) and 95% confidence intervals (CIs) representing the association.

Results Among 2,106 participants, 3% (n = 75) had early pregnancy SDB and 5.7% (n = 119) developed new-onset mid-pregnancy SDB. The incidence of the primary outcome was higher in the offspring of individuals with early (29.3%) and new onset mid-pregnancy SDB (30.3%) compared with individuals with no SDB (17.8%). After adjustment for maternal age, chronic hypertension, pregestational diabetes, and body mass index, new onset mid-pregnancy SDB conferred increased risk (RR = 1.43, 95% CI: 1.05, 1.94), where there was no longer statistically significant association between early pregnancy SDB and the primary outcome.

Conclusion New onset, mid-pregnancy SDB is independently associated with neonatal morbidity.

Key Points

SDB is a common condition impacting pregnancy with known maternal risks.
Objectively defined SDB in pregnancy was associated with a composite of adverse neonatal outcomes.
New onset SDB in mid pregnancy conferred statistically significant increased risk.

Keywords

neonatology - obstetrics - sleep disordered breathing

Volltext

Referenzen

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