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Preeclampsia and Baby Complications Correlated to High- Risk Score for Obstructive Sleep Apnea Screen by STOP- Bang Questionnaire

Lisa Sangkum MD¹, Saowanee Sawang MD¹, Visasiri Tantrakul MD², Chayada Tangshewinsirikul MD³, Sukanya Siriyotha MSc⁴, Sivaporn Termpornlert MD¹, Rojnarin Komonhirun MEd¹

Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ² Sleep Disorder Center and Division of Pulmonary and Critical Care, Medicine Department, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ³ Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ⁴ Department of Clinical Epidemiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Background: Obstructive sleep apnea (OSA) has been postulated as a risk factor for adverse maternal-fetal outcomes, especially preeclampsia. The physiological changes during pregnancy predispose a woman “at risk” towards developing OSA. Therefore, incidence of OSA may increase among pregnant population. STOP-Bang has been postulated as an acceptable screening tool for OSA in obstetric population.
Objective: To identify the correlation between preeclampsia and patients who were at risk of OSA, based on STOP-Bang, Berlin, and Epworth sleepiness scale.
Materials and Methods: A diagnostic prediction research was conducted using cross-sectional approach. Patients, who have STOP-Bang score of 3 or more and less than 3, were categorized as high-risk and low-risk for OSA, respectively. The relationship between high-risk OSA patients and preeclampsia were evaluated using logistic regression.
Results: Seven hundred and three patients were included, and 47 patients (6.7%) were diagnosed preeclampsia. Six hundred fifty and 53 patients were classified as low-risk and high-risk for OSA, respectively. Fifty percent of the high-risk group were complicated with preeclampsia compared with 2.8% in low-risk group. The odd ratio (OR) of having preeclampsia in high-risk group was 32.6 (95% CI 16.1 to 66.1). The pregnant women, classified as high-risk, were associated with neonatal complications by OR 3.4 (95% CI 1.4 to 8.2) but not maternal complications.
Conclusion: Among pregnant population, a STOP-Bang score of 3 or more is associated with the occurrence of preeclampsia and neonatal complications.
Received 14 May 2020 | Revised 20 March 2021 | Accepted 22 March 2021

doi.org/10.35755/jmedassocthai.2021.06.11400

Keywords : STOP-Bang questionnaire; Obstructive sleep apnea; Pregnancy; Preeclampsia


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