Recognition of obstructive sleep apnea in pregnancy survey

Background: Obstructive sleep apnoea (OSA) in pregnancy is associated with an increased morbidity and mortality to both mother and foetus. In the South African setting the proportion of pregnant females suffering from OSA has not been well studied; nor has the association with pre-eclampsia. This study aimed to determine the prevalence of OSA in females before 35 weeks gestation using the STOP-BANG questionnaire and to determine the association with pre-eclampsia in a local South African setting. Methods: A cross-sectional analytical study including 234 patients was conveniently sampled from Kalafong Hospital's antenatal ward, clinic and labour ward. Participants were of more than 20 weeks and less than 35 weeks gestation. All participants were interviewed with a modified STOP-BANG questionnaire. Patients were consecutively enrolled without prior knowledge of the presence of pre-eclampsia. At Kalafong hospital all pregnant patients are routinely screened and investigated for pre-eclampsia according to standard criteria. Results: The median gestational age in this sample was 28 weeks; 80.3% (CI 74.62-85.2%) of pregnant females had a low risk for OSA, 15.4% (CI 11.01-20.65%) had an intermediate risk and 3% (CI 6.47-14.58%) had a high risk for OSA. A modified STOP-BANG questionnaire had a sensitivity of 62.5% and a specificity of 82.1% for pre-eclampsia when a score of 3 and more was scored. Females at high risk of OSA had an OR of 8.4 (CI 2.88-24.6) for having pre-eclampsia. Conclusions: The authors report 15.4% of the study's pregnant population to be at intermediate risk and 3% at high risk of OSA. The association between the hypertensive disorders and OSA must be considered and screening implementation considered.

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“…15 The highest prevalence of OSA in the US group was in obese patients. 15 In our study group 41.5% of participants scored positive due to their …”

Section: Discussionmentioning

confidence: 93%

“…16 This could correspond to the increase in obesity, which is an independent risk factor for OSA and pre-eclampsia. 15,17 The median BMI for a pregnant South African female is 32, which places her in the obese group and increases her risk for OSA. The prevalence of pre-eclampsia in this sample was 6.8%.…”

Section: Resultsmentioning

confidence: 99%

Obstructive sleep apnoea in pregnancy and its association with pre-eclampsia

Lintott

Zyl

Burke

2016

Southern African Journal of Anaesthesia and Analgesia

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“…In this issue of the International Journal of Obstetric Anesthesia, Dominguez et al present a survey of members of the Society of Obstetric Anesthesia and Perinatology (SOAP) which focused on OSAawareness in pregnancy. 4 While most respondents accepted that OSA in pregnancy is a potential problem that can affect maternal and fetal well-being, the vast majority never screen their patients for OSA, and work in hospitals where there is no departmental policy for screening or management of OSA during pregnancy. In the few (<10%) respondents who did screen for OSA, most used the STOP-Bang screening tool, which may have limited utility during pregnancy.…”

Section: Gestational Sleep Apnea: Have We Been Caught Napping?mentioning

confidence: 99%

Gestational sleep apnea: have we been caught napping?

Karan

Ginosar

2016

International Journal of Obstetric Anesthesia

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“…With rising obesity rates, the incidence of OSA is likely to increase. A recent US survey found that the majority of anaesthetists were not aware of the risks of OSA, that antenatal screening does not often occur and that management guidelines were not available [4].…”

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confidence: 99%