Relationship between sleep-disordered breathing and perinatal outcome in pregnant women

Objective<br> The purpose of this study is to investigate the influence of sleep-disordered breathing (SDB) in pregnant women on birth outcomes.<br>Methods<br> The subjects were 179 females after Week 28 of pregnancy who had undergone pregnancy checkups in one obstetric hospital. We calculated the peripheral arterial blood ODI per hour during sleep at night by dividing the frequency at which the oxygen saturation did not reach the reference value by the duration of examination using a pulse oximeter.<br>Concerning the criteria, patients with a 3%ODI of less than 0.5 were regarded as showing the absence of SDB, those with values ranging from 0.5 to 4.9 as showing the normal range, those with values ranging from 5 to 14.9 as having mild SDB, those with values ranging from 15 to 29.9 as having moderate SDB, and those with a 3%ODI of 30 or more as having severe SDB.<br>Multiple logistic regression analysis was performed to assess the birth outcomes associated with SDB.<br>Results<br> The 3%ODI was less than 0.5 in 38 (21.2%), 0.5 to 4.9 in 119 (66.5%), and 5 to 14.9 in 22 (12.3%). Therefore, we compared a mild SDB group (3%ODI≥5, n=22) with a normal group (3%ODI<5, n=157).<br> We calculated the adjusted odds ratio (OR), regarding parity and obesity as confounding variables. Regarding spontaneous vaginal birth as the baseline, the adjusted OR of elective or emergency cesarean birth (CB)/vacuum extraction was 3.03 (95% Confidence Interval (CI): 1.10-8.33). Regarding elective CB/spontaneous vaginal birth as the baseline, the adjusted OR of emergency CB/vacuum extraction was 5.18 (95%CI: 1.44-18.65).<br>Conclusion<br> Mild SDB in pregnant women suggested that influence to the birth outcomes. Therefore, screening with a pulse-oximeter should be effectively utilized in multiparas with a history of spontaneous abortion and pregnant women complaining of frequent awakening at night or sleep disturbance. In addition, early intervention to improve the state of sleep and treat sleep disturbance may be necessary to promote a safer pregnancy.