The association between obstructive sleep apnea and the risk of poor delivery events in women: A population-based nested case-control study.
Jui-Chiung Sun, Chia-Ling Lin, Fei-Ling Wu and 3 others
PMID 34738319WHAT IT FOUND
Pregnant women with diagnosed obstructive sleep apnea were more likely to have poor delivery events, mainly premature delivery and abortion.
The link was stronger with longer apnea history and three or more comorbidities. Stillbirth was not linked.
Key findings
01Women with obstructive sleep apnea had significantly higher adjusted risk of poor delivery events than matched controls.
02The significant associations were for premature delivery and abortion; stillbirth did not show a significant association.
03Longer obstructive sleep apnea history was associated with higher adjusted risk, with odds ratios of 1.14 for less than 1 year and 1.26 for 2 years or more.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is an observational database study, so it can show association but cannot prove that obstructive sleep apnea caused poor delivery events. The database did not include obstructive sleep apnea severity measures such as apnea-hypopnea index or respiratory disturbance index, so the study could not evaluate whether severity was related to poor delivery events. Body mass index, tobacco, alcohol, drug use, and socioeconomic factors were not available, and these could explain part of the association. Women with obstructive sleep apnea who never sought care or assessment may not have been recorded, which could underestimate prevalence. The overall association was adjusted odds ratio 1.19, and stillbirth was not statistically significant (adjusted odds ratio 1.04, p 0.059). Because cases and controls were identified from insurance records, diagnosis coding and matching may have left residual bias from obesity and other conditions.
Declared interests
The authors reported no financial or nonfinancial conflicts of interest.
The easy way to misread this
Do not conclude that obstructive sleep apnea causes poor delivery events or that treating it will prevent them. This study used insurance diagnosis records without obstructive sleep apnea severity, body mass index, tobacco, alcohol, or treatment information, so the association may be partly due to other factors that were not measured or errors in diagnosis records.