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American Journal of Obstetrics and Gynecology | 2018

Screening extremely obese pregnant women for obstructive sleep apnea

Jennifer E. Dominguez; Chad Grotegut; Mary Cooter; Andrew D. Krystal; Ashraf S. Habib

BACKGROUND: Obesity is prevalent among pregnant women in the United States; obstructive sleep apnea is highly comorbid with obesity and is associated with adverse pregnancy outcomes. Screening for obstructive sleep apnea in pregnant women has remained a challenge because of a lack of validated screening tools. OBJECTIVE: The purpose of this study was to evaluate established obstructive sleep apnea screening tools, a sleepiness scale, and individual component items in a cohort of pregnant women with extreme obesity in mid pregnancy with the use of objective testing to determine obstructive sleep apnea status and to describe the prevalence of obstructive sleep apnea among women with extreme obesity. STUDY DESIGN: Adult pregnant subjects, between 24 and 35 weeks gestation, with a body mass index ≥40 kg/m2 at the time of enrollment completed obstructive sleep apnea screening tools (Berlin Questionnaire, American Society of Anesthesiologists checklist, and STOP‐BANG questionnaire) and the Epworth Sleepiness Scale; they also underwent physical examination of the neck, mouth, and airway. The published obstructive sleep apnea in pregnancy prediction score was calculated for each subject. Obstructive sleep apnea status for each subject was determined by the results of an overnight, unattended type III home sleep apnea test. RESULTS: Twenty‐four percent of pregnant women with extreme obesity had obstructive sleep apnea on home sleep apnea testing in mid pregnancy (Apnea‐Hypopnea Index, ≥5 events per hour]. Established obstructive sleep apnea screening tools performed very poorly to screen for obstructive sleep apnea in this cohort. Age, body mass index, neck circumference, frequently witnessed apneas, and highly likely to fall asleep while driving were associated most strongly with obstructive sleep apnea status in this cohort. CONCLUSION: We found that 24% of pregnant women with body mass index ≥40 kg/m2 between 24 and 35 weeks gestation have obstructive sleep apnea, defined as Apnea‐Hypopnea Index ≥5 events per hour on an overnight type III home sleep apnea test. We found the Berlin Questionnaire, American Society of Anesthesiologists checklist, STOP‐BANG, obstructive sleep apnea in pregnancy score by Facco et al, and the Epworth Sleepiness Scale were not useful screening tools for obstructive sleep apnea in a cohort of obese pregnant women. However, age, body mass index, neck circumference, frequently witnessed apneas, and likely to fall asleep while driving were associated with obstructive sleep apnea in this cohort. Further studies are needed to adjust the criteria and thresholds within the available screening tools to better predict obstructive sleep apnea in pregnant women with obesity.


Archive | 2015

Pre-existing Medical Conditions among Pregnant Women with

CardiomyopathyA Grotegut; Cary Ward; Margaret G. Jamison; Chad Grotegut


/data/revues/00029378/v214i1sS/S0002937815017366/ | 2015

390: Magnesium sulfate for neuroprotection in the setting of chorioamnionitis

James M. Edwards; Laura E. Edwards; Geeta Swamy; Chad Grotegut


/data/revues/00029378/v210i1sS/S0002937813011411/ | 2013

43: Medical and pregnancy complications among women with congenital heart disease at delivery

Jennifer Thompson; Elena V. Kuklina; Brian T. Bateman; William M. Callaghan; Andra H. James; Chad Grotegut


/data/revues/00029378/v208i1sS/S0002937812017152/ | 2012

466: Relationship of placental inflammation and progesterone in the setting or preterm birth

Amy Murtha; Brian Antczak; Chad Grotegut; R. Phillip Heine; Haywood L. Brown; Geeta Swamy


/data/revues/00029378/v208i1sS/S0002937812014184/ | 2012

Iconography : 170: Predictive modeling of anti-Xa activity with enoxaparin use in pregnancy

Avinash S. Patil; Chad Grotegut; Sarah K. Dotters-Katz; Geeta Swamy; Amy Murtha; Andra H. James


/data/revues/00029378/v208i1sS/S0002937812013300/ | 2012

82: Increase in cesarean operative times following institution of the 80-hour work week

Michael Smrtka; Ravindu Gunatilake; Benjamin Harris; Miao Yu; Lan Lan; Chad Grotegut; Haywood L. Brown


/data/revues/00029378/v208i1sS/S000293781201229X/ | 2012

808: The impact of maternal body mass index on cesarean delivery operative times

Michael Smrtka; Ravindu Gunatilake; Jennifer Thompson; Benjamin Harris; Miao Yu; Lan Lan; Terrence K. Allen; Chad Grotegut; Haywood L. Brown


/data/revues/00029378/v208i1sS/S0002937812011222/ | 2012

701: Pregnancy complications in women aged 50 years and older

Chad Grotegut; Christian A. Chisholm; R. Phillips Heine; Haywood L. Brown; Andra H. James


/data/revues/00029378/v204i1sS/S0002937810020855/ | 2011

804: Risk factors, rate and mortality associated with cardiomyopathy in pregnancy

Chad Grotegut; Margaret G. Jamison; Andra H. James

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