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Effects of gestational intermittent hypoxia on the respiratory system: A tale of the placenta, fetus, and developing
Esther Valverde-Pérez1,2, Elena Olea2,3, Asunción Rocher1,2
1Departamento de Bioquímica y Biología Molecular y Fisiología, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
Insights
Obstructive sleep apnea (OSA) during pregnancy poses risks to maternal and fetal health, increasing complications like pre-eclampsia. Addressing gestational intermittent hypoxia (GIH) is crucial for long-term health outcomes in mothers and offspring.
Area of Science:
- Obstetrics and Gynecology
- Pulmonology
- Cardiology
Background:
- Obstructive sleep apnea (OSA) is a prevalent condition linked to numerous health issues.
- Pregnancy exacerbates OSA due to physiological changes, increasing risks for hypertension, pre-eclampsia, and diabetes.
- Gestational OSA negatively impacts fetal development, leading to growth restrictions and low birth weight.
Purpose of the Study:
- To review the literature on the effects of gestational intermittent hypoxia (GIH) on the respiratory system.
- To provide current scientific data on OSA in pregnancy for improved management.
- To highlight the long-term health consequences for mothers and offspring.
Main Methods:
- Literature review focusing on studies examining gestational intermittent hypoxia (GIH).
- Analysis of research on maternal, fetal, and offspring respiratory system impacts.
- Synthesis of data on cardiovascular, metabolic, and neurocognitive manifestations.
Main Results:
- Intermittent hypoxia (IH) during pregnancy contributes to maternal cardiovascular disease and oxidative stress.
- GIH is associated with adverse fetal outcomes, including growth retardation and preterm birth.
- Hypoxia-reoxygenation cycles in utero may lead to lasting health problems in adulthood.
Conclusions:
- Gestational OSA is an underrecognized condition with significant risks for both mother and child.
- Understanding GIH impacts is vital for developing interventions to mitigate short- and long-term health consequences.
- Early management of OSA in pregnancy can improve maternal and offspring health trajectories.
Abstract:
Obstructive sleep apnea (OSA) is a common sleep disorder that is associated with a wide variety of health conditions, including cardiovascular, cerebrovascular, metabolic, neoplastic, and neurocognitive manifestations. OSA, as a chronic condition, is mainly characterised by repeated upper airway obstructions during sleep that cause episodes of intermittent hypoxia (IH), resulting in tissue hypoxia-reoxygenation cycles. Decreased arterial oxygen pressure (PaO2) and haemoglobin saturation (SatO2) stimulate reflex responses to overcome the obstruction. The prevalence of OSA is significant worldwide, and an underrated problem when focussing on women during pregnancy. The physiological changes associated with pregnancy, especially during its latest stages, are related to a higher prevalence of OSA events in pregnant mothers, and associated with an increased risk of hypertension, pre-eclampsia and diabetes, among other deleterious consequences. Furthermore, OSA during pregnancy can interfere with normal fetal development and is associated with growth retardation, preterm birth, or low birth weight. Carotid body overstimulation and hypoxia-reoxygenation episodes contribute to cardiovascular disease and oxidative stress, which can harm both mother and fetus and have long-lasting effects that can reach into adulthood. Because IH is the hallmark of OSA, this review examines the literature available about the impact of gestational intermittent hypoxia (GIH) on the respiratory system at maternal, fetal, and offspring levels. Offering the latest scientific data about OSA during pregnancy, we may help to tackle this condition with lifestyle changes and therapeutic approaches, that could influence the mothers, but also impact adult health problems, mostly unknown, inherited from these hypoxic episodes in the uterus.
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