Screening Tools for Obstructive Sleep Apnea in Pregnant Women: An Extended and Updated Systematic Review and...

Area of Science:

• Obstetrics and Gynecology
• Pulmonology
• Sleep Medicine

Background:

• Obstructive sleep apnea syndrome (OSA) prevalence rises during pregnancy, impacting maternal and fetal health.
• Accurate screening tools are crucial for timely diagnosis and management of OSA in pregnant individuals.

Purpose of the Study:

• To systematically review and meta-analyze the diagnostic validity of the Berlin, STOP-Bang, and Epworth sleepiness scale (ESS) questionnaires for OSA in pregnant women.
• To assess the sensitivity, specificity, and predictive values of these common screening tools in this specific population.

Main Methods:

• A systematic search of PubMed, Embase, and Web of Science databases was conducted up to March 2022.
• Data from 8 eligible studies involving 710 pregnant women with suspected OSA were extracted by two independent reviewers.
• Bivariate random-effects models were employed to calculate pooled accuracy measures, including sensitivity, specificity, PPV, NPV, and DOR.

Main Results:

• The Berlin questionnaire showed pooled sensitivity of 61% and specificity of 61%.
• The STOP-Bang questionnaire demonstrated pooled sensitivity of 59% and specificity of 80%.
• The Epworth Sleepiness Scale (ESS) exhibited pooled sensitivity of 29% and specificity of 80%, with overall poorer performance characteristics compared to the other two.

Conclusions:

• The Berlin, STOP-Bang, and ESS questionnaires demonstrate limited to moderate accuracy in screening for OSA in pregnant women.
• The ESS appears to be the least effective screening tool in this population.
• Further research is necessary to identify and validate more effective screening methods for OSA during pregnancy.