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Obstructive Sleep Apnea Among Gravidas With Chronic Hypertension Compared to Matched Controls: A Prospective Cohort
Jennifer E Dominguez1, Chad A Grotegut2, Mary Cooter Wright1
1From the Departments of Anesthesiology.
Anesthesia and Analgesia
|November 10, 2022
Summary
Chronic hypertension in pregnancy (cHTN) is linked to higher obstructive sleep apnea (OSA) risk, especially in older gravidas. Early OSA screening for pregnant individuals with cHTN is recommended.
Area of Science:
- Obstetrics and Gynecology
- Sleep Medicine
- Cardiology
Background:
- Obstructive sleep apnea (OSA) risk in pregnant individuals with chronic hypertension (cHTN) has not been adequately studied, particularly concerning obesity.
- Previous research failed to control for obesity, a known OSA risk factor, when examining cHTN and OSA in pregnancy.
Purpose of the Study:
- To determine if OSA is more prevalent in pregnant individuals with cHTN compared to normotensive individuals matched for BMI and gestational age.
- To assess if OSA severity is greater when comorbid with cHTN during pregnancy.
Main Methods:
- A single-center, prospective cohort study involving pregnant individuals (10-20 weeks gestation) with and without cHTN, matched for BMI.
- Utilized OSA screening questionnaires and home sleep tests for all participants.
- Employed univariable and multivariable logistic regression to analyze the association between cHTN and OSA.
Main Results:
- OSA was significantly more prevalent (64% vs. 38%) and severe (moderate/severe OSA 59% vs. 21%) in pregnant individuals with cHTN.
- While overall cHTN was not associated with OSA risk after controlling for age (aOR 2.22, P=.076), it was associated in those older than 25 (aOR 2.64, P=.038).
- Pregnant individuals with cHTN were older on average (34 vs. 30 years).
Conclusions:
- Chronic hypertension and advanced maternal age are significant risk factors for OSA in pregnancy.
- Recommend early pregnancy screening for OSA in pregnant individuals diagnosed with cHTN.
- Suggest future research to validate screening tools incorporating cHTN and age, and to explore OSA therapy's impact on blood pressure control.
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