Joint Effect of Body Mass Index and Obstructive Sleep Apnea on Preeclampsia Risk

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Sleep Medicine

Background:

• Preeclampsia is a leading cause of maternal and infant mortality globally.
• Identifying modifiable risk factors early in pregnancy is crucial for reducing preeclampsia incidence and adverse outcomes.
• The combined impact of prepregnancy body mass index (BMI) and obstructive sleep apnea (OSA) on preeclampsia risk requires further investigation.

Purpose of the Study:

• To investigate the potential synergistic effect of prepregnancy BMI and OSA on the risk of developing preeclampsia.
• To quantify the independent and combined risks associated with elevated BMI and OSA in singleton pregnancies.

Main Methods:

• Retrospective cohort study of over 340,000 singleton pregnancies.
• Ascertainment of preeclampsia and OSA using clinical diagnosis codes.
• Analysis of prepregnancy BMI categories (normal, overweight, obese) and OSA diagnosis using multivariable logistic regression.

Main Results:

• Overweight and obese BMI were independently associated with increased preeclampsia risk (aRR 1.6 and 2.5, respectively).
• Obstructive sleep apnea (OSA) was independently associated with increased preeclampsia risk (aRR 2.2).
• The combination of overweight or obese BMI with OSA significantly elevated preeclampsia risk (aRR 4.6 and 3.8, respectively), demonstrating an additive, not synergistic, effect.

Conclusions:

• Elevated prepregnancy BMI and OSA are independent risk factors for preeclampsia.
• The combined presence of obesity and OSA results in an additive increase in preeclampsia risk.
• Pregnant individuals with overweight BMI and OSA should receive close monitoring and early intervention for these modifiable risk factors.