Frequent, loud snoring increases the risk of preterm delivery: News from the sleep conference

Another interesting paper presented at the annual meeting of the Associated Professional Sleep Societies linking obstructive sleep apnea and preterm and early preterm delivery. Women who are frequent, loud snorers during pregnancy and also before they were pregnant have a definite higher risk of preterm delivery as compared to their counterpart who sleep soundly throughout night.

The paper was presented at the 31st Annual Meeting of the Associated Professional Sleep Societies LLC (APSS), Boston. by Galit Levi Dunietz, PhD, MPH, of the University of Michigan.

It is already known that women with Sleep disordered breathing (SDB) do not fare well in pregnancy and many particularly have maternal hypertension and diabetes and possibly fetal growth restriction.

The study looked at 904 non-hypertensive, non-diabetic women, pregnant women in their third trimester, attending a prenatal clinic at a large medical center.

The women were divided into 4 groups based on their snoring pattern: non-snorers, infrequent-quiet, frequent-quiet, or frequent-loud snorers.

Only 6% of women were frequent loud-snorers and about 50% did not snore at all. 

About 25% of women in the pre-pregnancy frequent, loud- snoring category had a preterm delivery.

After adjusting for all pre-pregnancy and pregnancy confounders, those women who were frequent loud-snorers had an 81% increased risk of preterm delivery.  

The mean time to delivery in frequent loud snoring group was 37.1 weeks as compared to 38.6 weeks in controls.

Non-loud, infrequent, or pregnancy-onset snorers did not face the risk for preterm delivery.

Galit Levi Dunietz, PhD, MPH, of the University of Michigan said, “The fact that there is an association between snoring and time to delivery in a cohort which is not hypertensive is alarming, and I think that treatment for snoring earlier on in pregnancy may alleviate some of these outcomes.”

She further added that “The combination of snoring frequency and intensity may be a clinically useful marker to identify otherwise low-risk women who are likely to deliver earlier.”

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North American Menopause Society (NAMS) video series about important midlife health topics:Individualizing Hormone Therapy

The North American Menopause Society (NAMS) has started comprehensive video series for clinicians about important midlife health topics. All the interviews in the series are hosted by NAMS Board of Trustees Member and President Dr. Marla Shapiro, a Canadian physician, who led this exciting initiative.

In this video The North American Menopause Society answers questions about individualizing hormone therapy—its history, recommendations, timing hypothesis, and routes of administration. Dr. Schnatz also discusses the concept of the appropriate dose with the appropriate route for the appropriate duration.

Obstructive sleep apnea in pregnancy linked to higher risk of congenital malformations: News from the sleep conference.

 Newborns of mothers with sleep apnea have higher chances of requiring resuscitation at birth, longer hospital stay and 26% higher risk of being born with a congenital malformation reports a study result presented at the 31st Annual Meeting of the Associated Professional Sleep Societies LLC (APSS), Boston.

This is first of its kind study linking Obstructive Sleep Apnea (OSA) in pregnancy and its effect on newborn.

The researchers looked at data from more than 1.4 million linked maternal and newborn records from National Perinatal Information Center over a period of 4 years from 2010-2014.

More than 17% of babies born to mother with OSA had congenital malformations. These mothers were also more likely to be tobacco and drug user, older, obese, and with pre-gestational hypertension and diabetes.

Only 10% of babies born to mother with no OSA had congenital anomalies (P < 0.001).

Most common anomalies were those related to circulatory system, nervous system and musculoskeletal.

Moreover, these newborns also had 2.76 times the risk of requiring resuscitation at birth and 2.25 times more likelihood of being in hospital for extended period of time.

“Our results have shown that babies born to mothers with a diagnosis of obstructive sleep apnea are more likely to require resuscitative efforts at birth, be born preterm, and to require a stay in the neonatal intensive care unit compared to babies who were not exposed to maternal sleep apnea,” said principal investigator and lead author Dr. Ghada Bourjeily, associate professor of medicine at Brown University and the Women’s Medicine Collaborative at The Miriam Hospital in Providence, Rhode Island.

“These findings add to our understanding of the extent of morbidities of maternal sleep apnea for the mother as well as the baby,” said Bourjeily. “The results further highlight the importance of identifying this condition in pregnancy and testing the impact of therapy on these complications.”

Dr. Bourjeily opined that results of this single study do not prove causation.

“We know that women who have sleep apnea also often have other morbidities, so we don’t know what might have contributed to the congenital outcomes,” said Dr. Bourjeily.

“We also don’t know if treating sleep apnea can reverse or prevent birth complications or even maternal complications, like preeclampsia or gestational diabetes.”

Studies are underway to look at maternal continuous positive airway pressure therapy use and neonatal outcomes.

Dr. Bourjeily received research equipment support from Respironics.