Your browser doesn't support javascript.
loading
Screening extremely obese pregnant women for obstructive sleep apnea.
Dominguez, Jennifer E; Grotegut, Chad A; Cooter, Mary; Krystal, Andrew D; Habib, Ashraf S.
Afiliação
  • Dominguez JE; Department of Anesthesiology, Duke University Medical Center, Durham, NC. Electronic address: Jennifer.dominguez@dm.duke.edu.
  • Grotegut CA; Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.
  • Cooter M; Department of Anesthesiology, Duke University Medical Center, Durham, NC.
  • Krystal AD; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC; Department of Psychiatry, University of California, San Francisco, San Francisco, CA.
  • Habib AS; Department of Anesthesiology, Duke University Medical Center, Durham, NC.
Am J Obstet Gynecol ; 219(6): 613.e1-613.e10, 2018 12.
Article em En | MEDLINE | ID: mdl-30217579
ABSTRACT

BACKGROUND:

Obesity is prevalent among pregnant women in the United States; obstructive sleep apnea is highly comorbid with obesity and is associated with adverse pregnancy outcomes. Screening for obstructive sleep apnea in pregnant women has remained a challenge because of a lack of validated screening tools.

OBJECTIVE:

The purpose of this study was to evaluate established obstructive sleep apnea screening tools, a sleepiness scale, and individual component items in a cohort of pregnant women with extreme obesity in mid pregnancy with the use of objective testing to determine obstructive sleep apnea status and to describe the prevalence of obstructive sleep apnea among women with extreme obesity. STUDY

DESIGN:

Adult pregnant subjects, between 24 and 35 weeks gestation, with a body mass index ≥40 kg/m2 at the time of enrollment completed obstructive sleep apnea screening tools (Berlin Questionnaire, American Society of Anesthesiologists checklist, and STOP-BANG questionnaire) and the Epworth Sleepiness Scale; they also underwent physical examination of the neck, mouth, and airway. The published obstructive sleep apnea in pregnancy prediction score was calculated for each subject. Obstructive sleep apnea status for each subject was determined by the results of an overnight, unattended type III home sleep apnea test.

RESULTS:

Twenty-four percent of pregnant women with extreme obesity had obstructive sleep apnea on home sleep apnea testing in mid pregnancy (Apnea-Hypopnea Index, ≥5 events per hour]. Established obstructive sleep apnea screening tools performed very poorly to screen for obstructive sleep apnea in this cohort. Age, body mass index, neck circumference, frequently witnessed apneas, and highly likely to fall asleep while driving were associated most strongly with obstructive sleep apnea status in this cohort.

CONCLUSION:

We found that 24% of pregnant women with body mass index ≥40 kg/m2 between 24 and 35 weeks gestation have obstructive sleep apnea, defined as Apnea-Hypopnea Index ≥5 events per hour on an overnight type III home sleep apnea test. We found the Berlin Questionnaire, American Society of Anesthesiologists checklist, STOP-BANG, obstructive sleep apnea in pregnancy score by Facco et al, and the Epworth Sleepiness Scale were not useful screening tools for obstructive sleep apnea in a cohort of obese pregnant women. However, age, body mass index, neck circumference, frequently witnessed apneas, and likely to fall asleep while driving were associated with obstructive sleep apnea in this cohort. Further studies are needed to adjust the criteria and thresholds within the available screening tools to better predict obstructive sleep apnea in pregnant women with obesity.
Assuntos
Palavras-chave

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Complicações na Gravidez / Diagnóstico Pré-Natal / Obesidade Mórbida / Apneia Obstrutiva do Sono Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adult / Female / Humans / Pregnancy País/Região como assunto: America do norte Idioma: En Revista: Am J Obstet Gynecol Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Complicações na Gravidez / Diagnóstico Pré-Natal / Obesidade Mórbida / Apneia Obstrutiva do Sono Tipo de estudo: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adult / Female / Humans / Pregnancy País/Região como assunto: America do norte Idioma: En Revista: Am J Obstet Gynecol Ano de publicação: 2018 Tipo de documento: Article