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Published online before print February 12, 2009, 10.1183/09031936.00122607
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Eur Respir J 2009; 33:559-565
Copyright ©ERS Journals Ltd 2009

Obstructive sleep apnoea and its association with gestational hypertension

K. Champagne1, K. Schwartzman1, L. Opatrny2, P. Barriga3, L. Morin4, A. Mallozzi4, A. Benjamin4 and R. J. Kimoff5

1 Dept of Medicine, Respiratory Epidemiology and Clinical Research Unit, McGill University, 2 Dept of Medicine, FetoMaternal Unit, McGill University, Depts of 4 Obstetrics and 5 Medicine, McGill University, and 3 Dept of Microbiology, Santa Cabrini Hospital, Montreal, QC, Canada.

CORRESPONDENCE: K. Champagne, Montreal Chest Institute, Respiratory Epidemiology and Clinical Research Unit, 3650 St-Urbain, Montreal, QC, Canada, H2X 2P4. Fax: 1 5148431695. E-mail: kateri.champagne{at}muhc.mcgill.ca

Keywords: Hypertension, obstructive sleep apnoea, pre-eclampsia, pregnancy, sleep-disordered breathing

Received: September 17, 2007
Accepted November 4, 2008

Hypertension develops in 10% of pregnancies. Snoring, a marker of obstructive sleep apnoea, is a newly identified risk factor for gestational hypertension. Moreover, obstructive sleep apnoea is an independent risk factor for incident hypertension in the non-pregnant population. The aim of the present study was to test the hypothesis that obstructive sleep apnoea is associated with new onset of hypertension among pregnant females.

A case–control study was performed involving 17 pregnant females with gestational hypertension and 33 pregnant females without hypertension. Subjects were frequency-matched for gestational age and recruited in a tertiary obstetrical centre. Obstructive sleep apnoea was ascertained by polysomnography and defined by an apnoea/hypopnoea index (AHI) of ≥15 events·h–1, without requirement for desaturation.

The mean±SD AHI for normotensive pregnant females was 18.2±12.2 events·h–1 compared with 38.6±36.7 events·h–1 for females with hypertensive pregnancies. The crude odds ratio for the presence of obstructive sleep apnoea given the presence of gestational hypertension was 5.6. The odds ratio was 7.5 (95% confidence interval 3.5–16.2), based on a logistic regression model with adjustment for maternal age, gestational age, pre-pregnancy body mass index, prior pregnancies, and previous live births.

In conclusion, gestational hypertension appears to be strongly associated with the presence of obstructive sleep apnoea.






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