Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts again. A new study by researchers has examined whether sleep-disordered breathing (mainly obstructive sleep apnea) during pregnancy and in the years following childbirth is associated with an increased risk of hypertension and metabolic syndrome. The study was published online in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.
Metabolic syndrome consisted of a group of conditions that increased the risk of heart disease, stroke, and diabetes. In “Sleep Disordered Breathing in Pregnancy and Post-Delivery: Associations with Cardiometabolic Health,” Francesca L. Facco, MD, Assistant Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal Fetal Medicine, UPMC Hospital Magee-Womens, Pittsburgh, and colleagues performed sleep apnea testing. Participants were a subset of 1,964 women who were part of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be Heart Health Study (nuMoM2b-HHS) and were experiencing their first pregnancy, and 1,222 of the same participants under study which were examined 2-7 years after delivery. The researchers then determined whether the participants were at increased risk for hypertension or metabolic syndrome.
“While epidemiological data from cohorts of middle-aged and older adults indicate that sleep disordered breathing is associated with adverse cardiometabolic outcomes, less is known about the impact of sleep disordered breathing during pregnancy and after childbirth on maternal health,” the authors said. Sleep-disordered breathing during pregnancy has been associated with a two to three times higher risk of preeclampsia (persistent high blood pressure during pregnancy that can lead to serious health consequences) and/or gestational diabetes (diabetes that develops during pregnancy). the pregnancy). These and other adverse pregnancy outcomes are risk factors for later development of hypertension and metabolic diseases in the mother.
Study participants were tested both during pregnancy and two to seven years later, each using the same home sleep apnea test model. Among other factors, sleep apnea tests measure the number of times a person experiences pauses in breathing and associated drops in oxygen levels. Study participants were considered to have sleep apnea if they experienced five or more pauses in breathing or drops in oxygen during their estimated sleep period. “We found that the presence of sleep apnea measured both during pregnancy and two to seven years postpartum was associated with the development of hypertension and metabolic syndrome,” Dr. Facco said.
Additionally, participants with sleep apnea that persisted through pregnancy and the two- to seven-year follow-up visit had a more than three-fold risk of incident hypertension and a more than two-fold risk of metabolic syndrome compared to participants who have never had a study on abnormal sleep. Incident hypertension is defined as the first occurrence, at a follow-up visit, of systolic blood pressure of 140 mm HG or greater or diastolic blood pressure of 90 mm HG or greater. “Our data also demonstrated a higher risk of developing metabolic syndrome and hypertension using a simple measure of oxygen declines per hour of sleep,” said study co-author Susan Redline, MD. MPH, who directs the sleep medicine epidemiology program at Brigham and Women’s. Hospital and Harvard Medical School, Boston. “These results suggest that the use of simple oxygen monitoring devices may be useful in identifying women during pregnancy and in the postpartum period at risk for adverse health effects and identifying women who may potentially benefit from sleep apnea treatment.”
“These data underscore the need to rigorously evaluate the role of sleep apnea screening and treatment during pregnancy and in the postpartum period as new early intervention strategies to improve long-term maternal health. term,” the authors concluded. (ANI)
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