INTRODUCTION: Obstructive sleep apnea (OSA) as diagnosed by polysomnography has been associated with preeclampsia and intrauterine growth restriction (IUGR). The use of validated screening tools in pregnancy is unknown. We sought to examine the association between a positive screen on one validated OSA tool, the STOP-BANG Questionnaire, and preeclampsia or IUGR.
METHODS: We performed a cross sectional study of pregnant women admitted to the antepartum unit. Demographic and pregnancy data were obtained from the medical record. Obstructive sleep apnea screening was performed using the STOP-BANG Questionnaire. The relationship between OSA screen positive status and the preeclampsia or IUGR was analyzed using a [chi]2 test for proportions and a multivariable logistic regression to control for potential confounders.
RESULTS: One hundred three pregnant women participated in the study; 19 (18.3%) screened positive on the STOP-BANG Questionnaire. Forty-two percent of women who screened positive had pregnancies complicated by preeclampsia compared with 13% who screened negative (P=.003). This association was maintained after adjusting for potential confounders (adjusted odds ratio 6.1, 95% confidence interval 1.7-22.1). There was no association between screen positive status and IUGR. Fifty-three percent of participants stated they would accept a formal sleep study during pregnancy if recommended by their health care provider. There was no difference in acceptance rate between screen negative and positive patients (50% compared with 68% P=.146).
CONCLUSION: In pregnancy, a positive screen on the STOP-BANG Questionnaire was associated with preeclampsia. Future studies are needed to validate the performance of this tool against polysomnography during pregnancy, which most participants stated they would be willing to complete.
(C) 2014 by The American College of Obstetricians and Gynecologists.