Questionnaire-Based Assessment of Obstructive Sleep Apnea Risk During Pregnancy: Associations with Metabolic...

Objective: Obstructive sleep apnea (OSA) during pregnancy is associated with adverse maternal and fetal outcomes, yet commonly used screening questionnaires may perform differently because of pregnancy-specific physiological changes. This study compared questionnaire-based OSA risk classifications obtained using the Berlin Questionnaire and STOP-BANG and examined their associations with metabolic parameters and diabetes-related history. Methods: This cross-sectional study included 210 pregnant women attending a tertiary obstetrics clinic. Berlin Questionnaire high risk was defined as positivity in at least two categories. STOP-BANG scores of 0-2, 3-4, and 5-8 indicated low, moderate, and high risk, respectively. Sociodemographic, obstetric, anthropometric, and biochemical variables were analyzed using multivariable logistic regression. Results: The Berlin Questionnaire classified 34 participants (16.2%) as high risk. STOP-BANG classified 183 (87.1%) as low risk, 5 (2.4%) as moderate risk, and 22 (10.5%) as high risk. Higher current weight was associated with increased questionnaire-based OSA risk according to both tools. In the Berlin model, HbA1c, BMI, and family history of diabetes were independently associated with high questionnaire-based OSA risk. No independent associations were identified in the STOP-BANG model. Although the Berlin model had 83.3% overall accuracy, it correctly classified only 2.9% of high-risk participants. Conclusions: The questionnaires identified different patterns of OSA risk. Findings were instrument-specific and do not indicate confirmed OSA. Given the absence of polysomnography, modest model performance, and limited high-risk classification, the results should be interpreted cautiously.