Maternal Obesity, Non-Respiratory Sleep Symptoms, Prescribed Nutritional Supplements and Routine Hematological...

Background/Objectives: Pregnant women with obesity may experience a substantial burden of sleep disruption and obstetric risk, but prospective data integrating non-respiratory sleep symptoms, prescribed nutritional supplement exposure, and routinely collected hematological measures are limited. This single-center prospective pilot study aimed to describe longitudinal changes in anthropometry, non-respiratory sleep symptoms, prescribed nutritional supplement exposure, routine hematological and blood-count-derived inflammatory indices, and obstetric and neonatal outcomes, and to document study-accrual and data completeness metrics for a future controlled cohort. Methods: Seventeen adult women with singleton pregnancies and first-trimester body mass index (BMI) ≥ 30 kg/m² reached the sleep unit, and all consented to participate. Protocol-based assessments were performed in the first and third trimesters, whereas routine laboratory and treatment data were extracted from medical records. Nutritional exposure was defined solely by prescription status in routine records; doses, formulations, adherence, dietary intake, and serum micronutrient markers were unavailable. Analyses were endpoint-specific complete-case analyses. Results: Study accrual at the sleep unit occurred from 27 July 2023 to 14 March 2024 (17 participants over 7.6 months; approximately 2.2 participants/month). The number informed in Obstetrics and the number not reaching the sleep unit were not recorded. Paired anthropometry was available for 15/17 participants, paired Epworth and Insomnia Severity Index scores for 14/17, paired restless-legs scores for 13/17, and delivery outcomes for 16/17. Median paired changes were 6.0 kg (IQR 1.4-7.9) for weight and 2.3 kg/m² (IQR 0.5-3.1) for BMI. Hemoglobin decreased, and selected blood-count-derived indices varied across routine trimester measurements. Sleep scores showed no clear longitudinal change, although nocturnal awakenings and subclinical insomnia were frequent. Type III polygraphy was attempted in all 17 participants at T1 and was valid in 16; one participant declined a repeat study after a technically invalid recording. Polygraphy was valid in 15 participants at T3; a respiratory event index (REI) ≥5 events/h was observed in 6/16 (37.5%) and 8/15 (53.3%), respectively. Conclusions: This pilot provides feasibility, data completeness, and variability estimates for a larger controlled cohort. The small uncontrolled sample, non-standardized laboratory timing, treatment heterogeneity, and missing upstream referral logs prevent obesity-specific, mechanistic, or clinically actionable conclusions.