Abstract
Objectives
Obstructive sleep apnea (OSA) is linked to many health comorbidities. We aimed to ascertain if OSA correlates with a rise in poor obstetrical outcomes.
Methods
Employing the United States’ Healthcare Cost and Utilization Project – National Inpatient Sample, we performed our retrospective cohort study including all women who delivered between 2006 and 2015. ICD-9 codes were used to characterize women as having a diagnosis of OSA. Temporal trends in pregnancies with OSA were studied, baseline features were evaluated among gravidities in the presence and absence of OSA, and multivariate logistic regression analysis was utilized in assessing consequences of OSA on patient and newborn outcomes.
Results
Of a total 7,907,139 deliveries, 3,115 belonged to patients suffering from OSA, resulting in a prevalence of 39 per 100,000 deliveries. Rates rose from 10.14 to 78.12 per 100,000 deliveries during the study interval (p<0.0001). Patients diagnosed with OSA were at higher risk of having pregnancies with preeclampsia, OR 2.2 (95% CI 2.0–2.4), eclampsia, 4.1 (2.4–7.0), chorioamnionitis, 1.4 (1.2–1.8), postpartum hemorrhage, 1.4 (1.2–1.7), venous thromboembolisms, 2.7 (2.1–3.4), and to deliver by caesarean section, 2.1 (1.9–2.3). Cardiovascular and respiratory complications were also more common among these women, as was maternal death, 4.2 (2.2–8.0). Newborns of OSA patients were at elevated risk of being premature, 1.3 (1.2–1.5) and having congenital abnormalities, 2.3 (1.7–3.0).
Conclusions
Pregnancies with OSA were linked to an elevated risk of poor maternal and neonatal outcomes. During pregnancy, OSA patients should receive attentive follow-up care in a tertiary hospital.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors report no conflicts of interest.
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Informed consent: This study was based on data from a pre-existing publicly available database from the United States: The Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS).
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
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