Brown NT, et al. - Researchers performed a systematic review and meta-analysis to ascertain if pregnant women diagnosed with sleep-disordered breathing are more likely to have adverse intrapartum and perinatal outcomes compared to controls. They noticed increased risks of adverse intrapartum and perinatal outcomes in association with maternal sleep-disordered breathing.

Methods

• Researchers searched PubMed, Embase and Cinahl databases for full text publications in English of sleep-disordered breathing and human pregnancy up to June 2017.
• They included studies reporting on sleep-disordered breathing in relation to gestational age or birth weight at delivery, pre-term birth, mode of delivery, cord pH, Apgar score, nursery admission, stillbirth or perinatal death, meconium at delivery or wound complications.

Results

• Inclusion criteria was met by a total of 1576 results identified with 33 studies.
• Women with sleep-disordered breathing were observed to be older (mean difference 1.66, 95% confidence interval 1.04 – 2.28) and had a higher body mass index (mean difference 3.31, 95% confidence interval 2.30 – 4.32) than those that did not.
• A significant association of maternal sleep-disordered breathing with pre-term birth (<37 weeks gestation) (odds ratio 1.86, 95% confidence interval 1.50 – 2.31) and low birth weight (<2500g) (odds ratio 1.67, 95% confidence interval 1.00 – 2.78) was observed.
• Women with sleep-disordered breathing less frequently had a vaginal delivery (odds ratio 0.61, 95% confidence interval 0.48 - 0.78) and were at a higher risk of having an assisted vaginal delivery (odds ratio 1.88, 95% confidence interval 1.10 – 3.21) or a cesarean (odds ratio 1.81, 95% confidence interval 1.55 – 2.11).
• These women showed an increased risk of both elective (odds ratio 1.38, 95% confidence interval 1.09 - 1.76) and emergency cesarean (odds ratio 2.52, 95% confidence interval 1.20 – 5.29).
• Moreover, a higher risk of having an infant with a 5-minute Apgar score <7 (odds ratio 2.14, 95% confidence interval 1.24 – 3.71), stillbirth or perinatal death (odds ratio 2.02, 95% confidence interval 1.25 - 3.28), and neonatal nursery admission (odds ratio 1.90, 95% confidence interval 1.38 – 2.61) was observed among these women.