Risk of birth defects in pregnant persons with sleep-disordered breathing during pregnancy.
birth defects
congenital malformations
oxidative stress
pregnancy
sleep apnea
sleep-disordered breathing
Journal
Birth defects research
ISSN: 2472-1727
Titre abrégé: Birth Defects Res
Pays: United States
ID NLM: 101701004
Informations de publication
Date de publication:
06 Nov 2023
06 Nov 2023
Historique:
revised:
28
09
2023
received:
24
05
2023
accepted:
24
10
2023
medline:
6
11
2023
pubmed:
6
11
2023
entrez:
6
11
2023
Statut:
aheadofprint
Résumé
As many as one in four pregnant women may experience sleep-disordered breathing (SDB) during pregnancy. The same sequelae of SDB, such as insulin resistance and inflammation, have been implicated in the development of certain birth defects. This is a secondary analysis of the SDB substudy of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be study, which included 2106 participants who had a sufficiency sleep study at two visits at different time points in pregnancy. SDB was based on a self-administered home sleep apnea test with data scored by trained, blinded research polysomnologists. SDB was defined as an apnea-hypopnea index (AHI) ≥5. The primary outcome of this analysis was any of the 45 non-chromosomal birth defects included in the National Birth Defects Prevention Network Annual Report. In this cohort, the overall rate of birth defects was 3.1%. The prevalence was similar between those without SDB (3.0%) and those with only mid-pregnancy SDB (3.4%), but was higher in those with early-pregnancy SDB (6.7%). After adjusting for maternal age, chronic hypertension, pregestational diabetes, and body mass index (BMI), there were no statistically significant differences in the risk of birth defects by subject SDB status. Further studies to evaluate the effect of prepregnancy and early-pregnancy SDB on the fetus, as well as the risk of specific birth defects and neonatal outcomes in those with an objectively measured diagnosis of SDB, are still needed.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Badran, M., Abuyassin, B., Ayas, N., & Laher, I. (2019). Intermittent hypoxia impairs uterine artery function in pregnant mice. Journal of Physiology, 597(10), 2639-2650. https://doi.org/10.1113/jp277775
Bourjeily, G., Danilack, V. A., Bublitz, M. H., Muri, J., Rosene-Montella, K., & Lipkind, H. (2020). Maternal obstructive sleep apnea and neonatal birth outcomes in a population based sample. Sleep Medicine, 66, 233-240. https://doi.org/10.1016/j.sleep.2019.01.019
Delgado, A., Kendle, A. M., Randis, T., Donda, K., Salemi, J. L., Facco, F. L., Parker, C. B., Reddy, U. M., Silver, R. M., Basner, R. C., Chung, J. H., Schubert, F. P., Pien, G. W., Redline, S., Parry, S., Grobman, W. A., Zee, P. C., & Louis, J. M. (2023). Association between sleep disordered breathing and neonatal outcomes in nulliparous individuals. American Journal of Perinatology. https://doi.org/10.1055/a-2115-0147
Dewan, N. A., Nieto, F. J., & Somers, V. K. (2015). Intermittent hypoxemia and OSA: Implications for comorbidities. Chest, 147(1), 266-274. https://doi.org/10.1378/chest.14-0500
Facco, F. L., Parker, C. B., Reddy, U. M., Silver, R. M., Koch, M. A., Louis, J. M., Basner, R. C., Chung, J. H., Nhan-Chang, C. L., Pien, G. W., Redline, S., Grobman, W. A., Wing, D. A., Simhan, H. N., Haas, D. M., Mercer, B. M., Parry, S., Mobley, D., Hunter, S., … Zee, P. C. (2017). Association between sleep-disordered breathing and hypertensive disorders of pregnancy and gestational diabetes mellitus. Obstetrics and Gynecology, 129(1), 31-41. https://doi.org/10.1097/aog.0000000000001805
Facco, F. L., Parker, C. B., Reddy, U. M., Silver, R. M., Louis, J. M., Basner, R. C., Chung, J. H., Schubert, F. P., Pien, G. W., Redline, S., Mobley, D. R., Koch, M. A., Simhan, H. N., Nhan-Chang, C. L., Parry, S., Grobman, W. A., Haas, D. M., Wing, D. A., Mercer, B. M., … Zee, P. C. (2015). NuMoM2b sleep-disordered breathing study: Objectives and methods. American Journal of Obstetrics and Gynecology, 212(4), 542.e1-542.e127. https://doi.org/10.1016/j.ajog.2015.01.021
Haas, D. M., Parker, C. B., Wing, D. A., Parry, S., Grobman, W. A., Mercer, B. M., Simhan, H. N., Hoffman, M. K., Silver, R. M., Wadhwa, P., Iams, J. D., Koch, M. A., Caritis, S. N., Wapner, R. J., Esplin, M. S., Elovitz, M. A., Foroud, T., Peaceman, A. M., Saade, G. R., … NuMoM2b study. (2015). A description of the methods of the nulliparous pregnancy outcomes study: Monitoring mothers-to-be (nuMoM2b). American Journal of Obstetrics and Gynecology, 212(4), 539.e1-539.e24. https://doi.org/10.1016/j.ajog.2015.01.019
Heinzer, R., Vat, S., Marques-Vidal, P., Marti-Soler, H., Andries, D., Tobback, N., Mooser, V., Preisig, M., Malhotra, A., Waeber, G., Vollenweider, P., Tafti, M., & Haba-Rubio, J. (2015). Prevalence of sleep-disordered breathing in the general population: The HypnoLaus study. Lancet Respiratory Medicine, 3(4), 310-318. https://doi.org/10.1016/s2213-2600(15)00043-0
Javaheri, S., Barbe, F., Campos-Rodriguez, F., Dempsey, J. A., Khayat, R., Javaheri, S., Malhotra, A., Martinez-Garcia, M. A., Mehra, R., Pack, A. I., Polotsky, V. Y., Redline, S., & Somers, V. K. (2017). Sleep apnea: Types, mechanisms, and clinical cardiovascular consequences. Journal of the American College of Cardiology, 69(7), 841-858. https://doi.org/10.1016/j.jacc.2016.11.069
Johns, E. C., Denison, F. C., & Reynolds, R. M. (2020). Sleep disordered breathing in pregnancy: A review of the pathophysiology of adverse pregnancy outcomes. Acta Physiologica, 229(2), e13458. https://doi.org/10.1111/apha.13458
Khokhrina, A., Andreeva, E., & Degryse, J. M. (2020). The prevalence of sleep-disordered breathing in Northwest Russia: The ARKHsleep study. Chronic Respiratory Disease, 17, 1479973120928103. https://doi.org/10.1177/1479973120928103
Laforgia, N., Di Mauro, A., Favia Guarnieri, G., Varvara, D., De Cosmo, L., Panza, R., Capozza, M., Baldassarre, M. E., & Resta, N. (2018). The role of oxidative stress in the pathomechanism of congenital malformations. Oxidative Medicine and Cellular Longevity, 2018, 7404082. https://doi.org/10.1155/2018/7404082
Laposky, A. D., & Pemberton, V. L. (2021). Sleep-disordered breathing and pregnancy-related cardiovascular disease. Journal of Women's Health, 30(2), 194-198. https://doi.org/10.1089/jwh.2020.8869
Llurba Olive, E., Xiao, E., Natale, D. R., & Fisher, S. A. (2018). Oxygen and lack of oxygen in fetal and placental development, feto-placental coupling, and congenital heart defects. Birth Defects Research, 110(20), 1517-1530. https://doi.org/10.1002/bdr2.1430
National Birth Defects Prevention Network (NBDPN). (2022). Birth defects data tables and directory, 2022.
Orrù, G., Storari, M., Scano, A., Piras, V., Taibi, R., & Viscuso, D. (2020). Obstructive sleep apnea, oxidative stress, inflammation and endothelial dysfunction-An overview of predictive laboratory biomarkers. European Review for Medical and Pharmacological Sciences, 24(12), 6939-6948. https://doi.org/10.26355/eurrev_202006_21685
Peppard, P. E., Young, T., Barnet, J. H., Palta, M., Hagen, E. W., & Hla, K. M. (2013). Increased prevalence of sleep-disordered breathing in adults. American Journal of Epidemiology, 177(9), 1006-1014. https://doi.org/10.1093/aje/kws342
Pien, G. W., Pack, A. I., Jackson, N., Maislin, G., Macones, G. A., & Schwab, R. J. (2014). Risk factors for sleep-disordered breathing in pregnancy. Thorax, 69(4), 371-377. https://doi.org/10.1136/thoraxjnl-2012-202718
Ravishankar, S., Bourjeily, G., Lambert-Messerlian, G., He, M., De Paepe, M. E., & Gündoğan, F. (2015). Evidence of placental hypoxia in maternal sleep disordered breathing. Pediatric and Developmental Pathology, 18(5), 380-386. https://doi.org/10.2350/15-06-1647-oa.1
Ritchie, H. E., Oakes, D. J., Kennedy, D., & Polson, J. W. (2017). Early gestational hypoxia and adverse developmental outcomes. Birth Defects Research, 109(17), 1358-1376. https://doi.org/10.1002/bdr2.1136
Robertson, N. T., Turner, J. M., & Kumar, S. (2019). Pathophysiological changes associated with sleep disordered breathing and supine sleep position in pregnancy. Sleep Medicine Reviews, 46, 1-8. https://doi.org/10.1016/j.smrv.2019.04.006
Warland, J., Dorrian, J., Morrison, J. L., & O'Brien, L. M. (2018). Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis. Sleep Medicine Reviews, 41, 197-219. https://doi.org/10.1016/j.smrv.2018.03.004