Incidence of Obstructive Sleep Apnea in Pregnancy
Obstructive sleep apnea is a condition characterized by obstruction of the upper airways and episodes of apnea and hypopnea during sleep. It is associated with significant adverse health effects. The incidence of obstructive sleep apnea in the general female population is approximately 2% but the incidence of obstructive sleep apnea in pregnancy is unknown. There is some evidence that pregnancy precipitates or at least exacerbates this condition and that there may be a relationship between intrauterine fetal growth retardation and maternal preeclampsia. In addition, there are several anesthetic implications that are concern for the patient with obstructive sleep apnea. These include: exquisite sensitivity to all central nervous system depressant drugs and the potential for upper airway obstruction or apnea with even minimal drug doses; difficult mask ventilation; difficult intubation; arterial hypoxemia; arterial hypercarbia; polycythemia; hypertension; pulmonary hypertension and cardiac failure. All of these conditions pose significant anesthetic risk for the patient, and this risk may be increased further by pregnancy.
Description
All patients presenting to the Prentice Women’s Hospital’s (PWH) Labor and Delivery Unit for spontaneous labor, induction of labor and scheduled cesarean delivery are routinely interviewed by a member of the anesthesia team to obtain a detailed history and physical examination and to discuss labor analgesia options. Immediately following this usual and customary preanesthetic evaluation the member of the anesthesia team performing the preanesthetic consultation (anesthesiology attending, resident physician, or nurse) used a standard verbal consent script to obtain verbal consent from the subject for study participation. Study participants were asked to complete a written validated survey, the Berlin Questionnaire, evaluating self-reported snoring and daytime sleepiness as well as basic demographic data (age, height, current weight and pregnancy weight gain). Survey completion time was 1 to 2 minutes.
The survey was available in English and Spanish. It did not contain any subject personal health information. The survey sheet remained in the labor and delivery room with the subject’s usual anesthesia medical record paperwork until the patient was discharged from the unit. At the time of discharge, the infant’s birthweight and APGAR scores were recorded on the survey and the survey collected.
All female patients, ages 18 - 45, presenting to the PWH Operating Room for elective gynecologic surgery, and all female patients, ages 18 - 45, presenting to the Northwestern Memorial Hospital (NMH) Ambulatory Surgery Center were interviewed by a member of the anesthesia team to obtain a routine preoperative history and physical examination and to discuss the anesthesia options. Immediately following this usual and customary preanesthetic evaluation the member of the anesthesia team performing the preanesthetic consultation (anesthesiology attending, resident physician, or certified registered nurse anesthetist) used a standard verbal consent script to obtain verbal consent from the subject for study participation. Study participants were asked to complete a written validated survey, the Berlin Questionnaire, evaluating self-reported snoring and daytime sleepiness as well as basic demographic data (age, height, and weight). The survey was available in English and Spanish. Survey completion time was 1-2 minutes. The survey did not contain any patient identifying information and was collected after completion.
Status: Completed (N/A). Started on September 1st, 2005.
Enrollment: 4577 subjects
Study Type: Observational
Study Design:
- Observational Model: Cohort
- Time Perspective: Prospective
Conditions:
Interventions:
- Procedure: Survey: Berlin questionnaire
Eligibility
Inclusion Criteria:
Pregnant Females
18 years of age and older
scheduled induction of labor
spontaneously laboring
scheduled cesarean delivery
Nonpregnant Females
18 years of age or older
presenting to the PWH OR for gynecologic surgery
presenting to the NMH Ambulatory Surgery Center for ambulatory surgery
Exclusion Criteria:
patient refusal
patient age > 45 years old
inability to understand the English language
patient presenting for an emergency procedure
- Gender
Female
- Mininum Age
18 Years
- Maximum Age
45 Years
- Healthy Volunteers
Accepts Healthy Volunteers
Resources
Source: Northwestern University
Authority: United States: Institutional Review Board
Locations
-
Northwestern University
Chicago
Illinois
60611
United States
Officials
Cynthia A Wong, M.D. (Principal Investigator, Northwestern University)
Sponsors
Northwestern University (Lead Sponsor)
References
Roush SF, Bell L. Obstructive sleep apnea in pregnancy. J Am Board Fam Pract. 2004 Jul-Aug;17(4):292-4.
PMID: 15243018.
Check for Full TextYoung T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002 May 1;165(9):1217-39. Review.
PMID: 11991871.
Check for Full TextGuilleminault C, Kreutzer M, Chang JL. Pregnancy, sleep disordered breathing and treatment with nasal continuous positive airway pressure. Sleep Med. 2004 Jan;5(1):43-51.
PMID: 14725826.
Check for Full TextNetzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999 Oct 5;131(7):485-91.
PMID: 10507956.
Check for Full Text
Links
None.
- Date Verified
- April 1st, 2011
- First Received
- April 25th, 2011
- Last Changed
- April 25th, 2011
Information obtained from ClinicalTrials.gov on June 09, 2011. Link to the current ClinicalTrials.gov record.
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