Sleep Apnea During Pregnancy Associated with Risk of Hypertension, Metabolic Syndrome

Primarily obstructive sleep apnea, also known as sleep disordered breathing, during pregnancy and in the years after delivery may be associated with an increased risk for hypertension and metabolic syndrome, according to the results of a new study.

The findings were published online in the American Journal of Respiratory and Critical Care Medicine, the journal of the American Thoracic Society.

In the study, investigators conducted sleep apnea tests on 1965 women who were part of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be Heart Health Study and experiencing their first pregnancy. Additionally, they also tested 1222 women of the same study who were examined 2 to 7 years after delivery.

Investigators determined whether individuals were at increased risk for hypertension or metabolic syndrome.

“While epidemiologic data from cohorts of middle-aged and older adults indicate that sleep disordered breathing is associated with adverse cardiometabolic outcomes, less is known about how sleep-disordered breathing in pregnancy and in the post-delivery period impacts maternal health,” investigators from the UPMC Magee Womens Hospital said in a statement.

Sleep disordered breathing during pregnancy has been associated with a 2- to 3-fold increased risk for preeclampsia, which is persistent high blood pressure during pregnancy that can lead to serious health consequences, such as gestational diabetes.

Other adverse pregnancy outcomes are risk factors for later development of hypertension and metabolic disease for the mother.

Additionally, individuals with sleep apnea that persisted during pregnancy and during follow-up visits between 2 and 7 years after delivery had more than a 3-fold increased risk for incident hypertension and more than a 2-fold increased risk for metabolic syndrome compared with those who never participated in an abnormal sleep study.

Incident hypertension was defined as the first occurrence at any follow-up visit of diastolic blood pressure 90 mm HG or higher or systolic blood pressure 140 mm HG or higher.

“Our data also demonstrated a higher risk of developing metabolic syndrome and hypertension using a simple measurement of oxygen dips per hour of sleep,” Susan Redline, MD, MPH, who directs the Sleep Medicine Epidemiology program at Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, said in the statement. “These results suggest that use of simple oxygen monitoring devices may be useful for identifying women in pregnancy and in the post-delivery period at risk for adverse health outcomes and identifying women who may potentially benefit from treating sleep apnea.”.

Individuals in the study were tested both during pregnancy and 2 to 7 years later, each using the same model home sleep apnea test. Among other factors, sleep apnea tests measure the number of times an individual experiences breathing pauses and associated drops in oxygen levels.

The individuals were considered to have sleep apnea if they experienced 5 or more breathing pauses or drops in oxygen during their estimated sleep period.

“These data underscore the need to rigorously evaluate the role of screening and treating sleep apnea during pregnancy and in the post-delivery period as new strategies for early interventions aimed at improving long-term maternal health,” investigators said.

Reference

Sleep apnea in pregnancy associated with increased post-delivery risk of metabolic syndrome, hypertension. EurekAlert. News release. February 11, 2022. Accessed February 15, 2022. https://www.eurekalert.org/news-releases/942602