Mild Maternal Obstructive Sleep Apnea in Non-obese Pregnant Women and Accelerated Fetal Growth

Abstract

The prevalence of obstructive sleep apnea (OSA) during pregnancy is rising. OSA during pregnancy has been associated with hypertensive disorders of pregnancy and gestational diabetes. The effect of maternal OSA on the fetus, particularly on fetal growth, is less apparent. Most of the currently available human data is based on non-objective assessment of OSA and includes heterogeneous populations with inadequate control on confounders, such as maternal obesity and pregnancy complications. Using objective tools in non-obese women with uncomplicated pregnancies, we aimed to investigate the association between maternal OSA and fetal growth. A total of 155 non-obese pregnant women were recruited. Birth-weight percentile of the newborns of women with mild OSA was significantly higher compared with the newborns of non-OSA controls (72% vs. 57%, respectively, P < 0.01). Birth-length and triceps thickness measurements were significantly higher among the newborns of women with OSA compared with controls (P = 0.02 for both). The proportion of large for gestational age (LGA) newborns was higher among women with OSA compared with controls (28% vs. 8%, respectively, P = 0.04). Our results suggest that maternal OSA during the third trimester of pregnancy - even in a mild form -is associated with accelerated fetal growth.

Gestational intermittent hypoxia induces endothelial dysfunction, reduces perivascular adiponectin and causes epigenetic changes in adult male offspring

“…Conflicting data may stem from limited literature using objective measures of OSA and birth weights, as well as inadequate control for confounding factors (Telerant et al . ; Warland et al . ).…”

“…The effects of OSA in pregnant women on birth weights are controversial. Some studies show reduced fetal growth, whereas others show no effect or even accelerated growth (Kneitel et al 2018;Telerant et al 2018). Conflicting data may stem from limited literature using objective measures of OSA and birth weights, as well as inadequate control for confounding factors (Telerant et al 2018;Warland et al 2018).…”

“…Some studies show reduced fetal growth, whereas others show no effect or even accelerated growth (Kneitel et al 2018;Telerant et al 2018). Conflicting data may stem from limited literature using objective measures of OSA and birth weights, as well as inadequate control for confounding factors (Telerant et al 2018;Warland et al 2018). Growth restriction in humans early in gestation increases the probability of developing obesity later in life, especially if combined with rapid compensatory growth after birth (Parsons et al 2001).…”

Intermittent hypoxia impairs uterine artery function in pregnant mice

“…However, there are also reports that OSA does not affect fetal weight and even accelerates fetal growth during the third trimester (Telerant et al . ). Conflicting results may stem from non‐objective tools used for assessment and inadequate control of confounding factors (Telerant et al .…”

“…Conflicting results may stem from non‐objective tools used for assessment and inadequate control of confounding factors (Telerant et al . ). We show that exposing pregnant mice to GIH reduced fetal weight at day 14.5 of pregnancy.…”