The intrapartum and perinatal risks of Sleep-Disordered Breathing in pregnancy: a systematic review and meta-analysis

Brown, Nicole T., Turner, Jessica M. and Kumar, Sailesh (2018) The intrapartum and perinatal risks of Sleep-Disordered Breathing in pregnancy: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, . doi:10.1016/j.ajog.2018.02.004


Author Brown, Nicole T.
Turner, Jessica M.
Kumar, Sailesh
Title The intrapartum and perinatal risks of Sleep-Disordered Breathing in pregnancy: a systematic review and meta-analysis
Journal name American Journal of Obstetrics and Gynecology   Check publisher's open access policy
ISSN 1097-6868
0002-9378
1085-8709
Publication date 2018-02-15
Year available 2018
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.ajog.2018.02.004
Open Access Status Not yet assessed
Total pages 46
Place of publication Philadelphia, PA United States
Publisher Mosby
Abstract Sleep-disordered breathing is an increasingly common condition in non-obstetric populations and is associated with significant morbidity. The incidence of sleep-disordered breathing in pregnancy is unknown and it is likely that many cases go undiagnosed.

A systematic review and meta-analysis was undertaken to determine if pregnant women diagnosed with sleep-disordered breathing are more likely to have adverse intrapartum and perinatal outcomes compared to controls.

PubMed, Embase and Cinahl databases were searched for full text publications in English of sleep-disordered breathing and human pregnancy up to June 2017. Only studies that reported on sleep-disordered breathing in relation to gestational age or birth weight at delivery, pre-term birth, mode of delivery, cord pH, Apgar score, nursery admission, stillbirth or perinatal death, meconium at delivery or wound complications were included.

A total of 1576 results were identified with 33 studies meeting inclusion criteria. Women with sleep-disordered breathing were older (mean difference 1.66, 95% confidence interval 1.04 - 2.28) and had a higher body mass index (mean difference 3.31, 95% confidence interval 2.30 - 4.32) than those that did not. Maternal sleep-disordered breathing was significantly associated with pre-term birth (<37 weeks gestation) (odds ratio 1.86, 95% confidence interval 1.50 - 2.31) and low birth weight (<2500g) (odds ratio 1.67, 95% confidence interval 1.00 - 2.78). These women were also less likely to have a vaginal delivery (odds ratio 0.61, 95% confidence interval 0.48 - 0.78) and at a higher risk of having an assisted vaginal delivery (odds ratio 1.88, 95% confidence interval 1.10 - 3.21) or a cesarean (odds ratio 1.81, 95% confidence interval 1.55 - 2.11). The risk of both elective (odds ratio 1.38, 95% confidence interval 1.09 - 1.76) and emergency cesarean (odds ratio 2.52, 95% confidence interval 1.20 - 5.29) was increased. In addition, women with sleep disordered breathing were at a higher risk of having an infant with a 5-minute Apgar score <7 (odds ratio 2.14, 95% confidence interval 1.24 - 3.71), stillbirth or perinatal death (odds ratio 2.02, 95% confidence interval 1.25 - 3.28), and neonatal nursery admission (odds ratio 1.90, 95% confidence interval 1.38 - 2.61).

Maternal sleep-disordered breathing is associated with increased risks of adverse intrapartum and perinatal outcomes.
Keyword Apgar score
birth weight
cesarean delivery
cord artery pH
instrumental operative delivery
meta-analysis
neonatal nursery admission
obstructive sleep apnea
perinatal death
pregnancy outcomes
sleep disordered breathing
snoring
stillbirth
systematic review
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Mater Research Institute-UQ (MRI-UQ)
HERDC Pre-Audit
Faculty of Medicine
 
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Created: Wed, 21 Feb 2018, 11:01:58 EST