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. 2012 Dec;207(6):487.e1-9.
doi: 10.1016/j.ajog.2012.08.034. Epub 2012 Sep 7.

Pregnancy-onset Habitual Snoring, Gestational Hypertension, and Preeclampsia: Prospective Cohort Study

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Pregnancy-onset Habitual Snoring, Gestational Hypertension, and Preeclampsia: Prospective Cohort Study

Louise M O'Brien et al. Am J Obstet Gynecol. .
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Abstract

Objective: This study aimed to prospectively examine the impact of chronic vs pregnancy-onset habitual snoring on gestational hypertension, preeclampsia, and gestational diabetes.

Study design: Third-trimester pregnant women were recruited from a large, tertiary medical center from March 2007 through December 2010 and screened for the presence and duration of habitual snoring, as a known marker for sleep-disordered breathing. Clinical diagnoses of gestational hypertension, preeclampsia, and gestational diabetes were obtained.

Results: Of 1719 pregnant women, 34% reported snoring, with 25% reporting pregnancy-onset snoring. After adjusting for confounders, pregnancy-onset, but not chronic, snoring was independently associated with gestational hypertension (odds ratio, 2.36; 95% confidence interval, 1.48-3.77; P < .001) and preeclampsia (odds ratio, 1.59; 95% confidence interval, 1.06-2.37; P = .024) but not gestational diabetes.

Conclusion: New-onset snoring during pregnancy is a strong risk factor for gestational hypertension and preeclampsia. In view of the significant morbidity and health care costs associated with hypertensive diseases of pregnancy, simple screening of pregnant women may have clinical utility.

Conflict of interest statement

Potential Conflicts of Interest:

Dr. O’Brien has received equipment support from Philips Respironics Inc. and has served on an advisory board for GlaxoSmithKline. Dr. Chervin receives educational grants from Philips Respironics Inc., Fisher Paykel Inc., is named in patents owned by the University of Michigan for signal analysis diagnostic algorithms and hardware relevant to the assessment and treatment of sleep disorders, and serves on the Board of Directors of the American Academy of Sleep Medicine. None of the other authors have conflicts to disclose.

Figures

Figure 1
Figure 1
Recruitment flow chart
Figure 2
Figure 2
Adjusted odds ratio, and 95%CI of maternal morbidity by obesity and snoring status 95%CI = 95% Confidence Intervals A. Odds ratio for gestational hypertension by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for weight gain in excess of IOM recommendations, gravidity, and history of gestational hypertension/pre-eclampsia. B. Odds ratio for pre-eclampsia by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for weight gain in excess of IOM recommendations, gravidity, race, history of gestational hypertension/pre-eclampsia, smoking, chronic hypertension, and gestational diabetes. C. Odds ratio for gestational diabetes by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for pre-pregnancy BMI and education level.
Figure 2
Figure 2
Adjusted odds ratio, and 95%CI of maternal morbidity by obesity and snoring status 95%CI = 95% Confidence Intervals A. Odds ratio for gestational hypertension by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for weight gain in excess of IOM recommendations, gravidity, and history of gestational hypertension/pre-eclampsia. B. Odds ratio for pre-eclampsia by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for weight gain in excess of IOM recommendations, gravidity, race, history of gestational hypertension/pre-eclampsia, smoking, chronic hypertension, and gestational diabetes. C. Odds ratio for gestational diabetes by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for pre-pregnancy BMI and education level.
Figure 2
Figure 2
Adjusted odds ratio, and 95%CI of maternal morbidity by obesity and snoring status 95%CI = 95% Confidence Intervals A. Odds ratio for gestational hypertension by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for weight gain in excess of IOM recommendations, gravidity, and history of gestational hypertension/pre-eclampsia. B. Odds ratio for pre-eclampsia by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for weight gain in excess of IOM recommendations, gravidity, race, history of gestational hypertension/pre-eclampsia, smoking, chronic hypertension, and gestational diabetes. C. Odds ratio for gestational diabetes by obesity and snoring status HS = Habitual Snoring Odds ratios are adjusted for pre-pregnancy BMI and education level.

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