Results
In all, 86 pregnant women with a BMI >35 met the inclusion
criteria; 19 were finally excluded because they had not undergone
polysomnography (Figure 1). This statistical analysis included 67
patients. The characteristics of the excluded women did not differ
significantly from those of the others. Table 1 presents the 67 women’s
characteristics: their mean age was 30.5 years ± 4.9, and their mean BMI
42.4 ± 6.2. Fourteen (20.90%) had a history of chronic hypertension or
diabetes.
Our principal objective was to assess the prevalence of OSA in our
population. Among these 67 pregnant women, 29 (43.3%, 95% CI,
31.4–55.2) had OSA, 25 of them mild or moderate and 4 severe (Figure
1). These women’s median AHI was 10.9 (9.15-19.7) and their median time
with oxygen saturation <90% 4 minutes (1-13 minutes). Of the
four women with severe OSA, only three agreed to start CPAP treatment
and only one continued it to the end of her pregnancy.
The first of our secondary objectives was to compare the OSA and non-OSA
populations for several criteria (Table 2). During pregnancy, women with
OSA developed gestational diabetes more often: 48.3% (n=14) compared
with 23.7% in the non-OSA group (n=9) (P =0.04). There were no
significant differences for weight gain, hospitalization during
pregnancy, or the vascular disease composite criterion, although we note
there was a trend toward more complications in the OSA group (n=10 vs
n=6, 34.5% vs 16.2%, P =0.086). Among the characteristics of
delivery, the groups did not differ significantly for rates of vaginal
delivery, cesarean delivery, or labor induction
(P >0.05). Similarly, there were no significant
differences for neonatal characteristics: birth weight was 3165 g ±
937.5 in the OSA group and 3292 g ± 644.7 in the non-OSA group
(P =0.98) with respectively, a pH of 7.24 ± 0.10 and 7.24 ± 0.09
(P =0.99) and 4 (13.79%) and 3 (8.33%) NICU admissions
(P =0.69).
The second of our secondary objectives was to study whether various
criteria, including age, parity, BMI, history of chronic hypertension,
history of diabetes, family history of OSA, weight gain during
pregnancy, and gestational diabetes, might be risk factors for
developing OSA in this population. A significant difference was observed
between the groups for women’s age, prepregnancy history of
hypertension, gestational diabetes, and mean BMI (Table 3). The mean age
of the women in the OSA group was 31.9 ± 4.7 years vs 29.5 ± 4.8 years
(P =0.045) in the women with this sleep problem, and their mean
BMI respectively 43.8 ± 6.2 kg/m2 and 41.2 ± 6
kg/m2 (P =0.045). Prepregnancy hypertension was
found in 11 women with OSA (37.9%) and only 3 without it (7.9%)
(P =0.0027). Gestational diabetes occurred among 48.3% of the
women with OSA (n=14) and 23.7% in those without it (n=9,P =0.036). We observed no significant differences between the
groups (P >0.05) for the other criteria studied:
parity, prepregnancy diabetes, family history of OAS, and weight gain
during pregnancy.