Snoring in Pregnant Hypertensive Women a Marker for Apnea Risk

Pregnant women with hypertension who also snored were found to be at high risk for obstructive sleep apnea, spurring the need for obstetric healthcare providers to consider sleep evaluation in hypertensive pregnancies.

Researchers at the University of Michigan (U-M) in Ann Arbor, led by Louise O’Brien, PhD, assessed 51 women with chronic hypertension, gestational hypertension, or preeclampsia and compared them with 16 normotensive pregnant women. All of the women completed a questionnaire about habitual snoring and underwent overnight ambulatory polysomnography.

“We know that habitual snoring is linked with poor pregnancy outcomes for both mother and child, including increased risk of C-sections and smaller babies,” O’Brien, associate professor at U-M’s Sleep Disorders Center in the Department of Neurology and adjunct associate professor in the Department of Obstetrics & Gynecology at the U-M Medical, said in a statement.

A significantly higher percentage of the women who were hypertensive snored (61% vs 19%; P = 0.008), and among the hypertensive women the risk of sleep apnea was twice as high in those who said they snored (relative risk, 2.0; 95% confidence interval, 1.4-2.8). The women who snored had a higher average apnea/hypopnea index (19.9 vs 3.4; P = 0.013) and a lower oxyhemoglobin saturation nadir (86.4 vs 90.2; P = 0.021).

Those who did not snore were more likely to have mild apnea and more than a quarter of those who snored had moderate-to-severe apnea.

“Hypertensive pregnant women who report snoring should be evaluated for obstructive sleep apnea since sleep apnea can be treated during pregnancy,” O’Brien said. “Prompt recognition, evaluation, and management will not only improve health benefits for both moms and babies but may also help cut the high healthcare expenses of operative deliveries, taking care of babies who are admitted to the NICU and other associated health risks.”

Further studies are needed, including longitudinal as well as treatment intervention studies, the authors noted. The study was published in the June 2, 2014, issue of the British Journal of Obstetrics and Gynecology.