Correlation between sleep apnea hypopnea syndrome and preeclampsia and the possible pathogenesis of preeclampsia / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between sleep apnea-hypopnea syndrome (SAHS) and preeclampsia and the possible pathogenesis of the latter.</p><p><b>METHODS</b>Twenty-five healthy pregnant women, 43 pregnant women with preeclampsia, and 27 with preeclampsia complicated by SAHS were enrolled in this study. Apnea-hypopnea index (AHI) and the lowest arterial oxygen saturation (LSaO2) were measured through a 7-hour polysomnography (PSG), and the maternal age, gestational age, body mass index and 24-hour urine protein were recorded.</p><p><b>RESULTS</b>All the indexes except for the maternal age and gestational age showed significant differences between the 3 groups. The two groups of preeclampsia patients showed a significant difference in BMI from the control cases. Significant positive correlations of AHI to BMI, MAP and 24-hour urine protein were noted; LSaO2 was found to inversely correlate to BMI, MAP, and 24-hour urine protein. In spite of the significant correlation of BMI to the other indexes, we found that BMI was less important than AHI and LSaO2.</p><p><b>CONCLUSION</b>SAHS may induce or aggravate preeclampsia. Greater attention should be given to the presence of SAHS in pregnant women with obesity, but obesity is not the predominant predisposing factor for preeclampsia.</p>

Clinical application of the Epworth sleepiness score in pregnant women with obstructive sleep apnea-hypopnea syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To provide a convenient method for screening obstructive sleep apnea-hypopnea syndrome (OSAHS) in pregnant women.</p><p><b>METHODS</b>Seventy-eight pregnant women with suspected OSAHS were calculated for the EP index using Epworth sleepiness score (ESS) with also measurement of the neck circumference (NC) and body mass index (BMI). The apnea/hypopnea index (AHI) was calculated and the lowest SaO(2) (LSaO(2)) measured through a 7-h polysomnography (PSG). The women were then divided into 4 groups according to the AHI and LSaO(2). The ESS was compared with the PSG-AHI and the receiver operating characteristic curve (ROC) was generated.</p><p><b>RESULTS</b>All the clinical indexes (NC, BMI, EP, AHI, and LSaO(2)) showed significant differences between the 4 groups (P<0.05). EP and PSG were found to have greater correlations to AHI (r=0.759, P=0.000) than NC (r=0.668) and BMI (r=0.663). The area under the ROC of the EP (0.825) was greater than that of NC (0.772) and BMI (0.784). The index of EP showed greater clinical diagnostic value of OSAHS in pregnancy. Base on the ROC, EP at the optimal operating point of 7.5 had a sensitivity of 76.8% and specificity of 68.2% for diagnosis of OSAHS in pregnant women.</p><p><b>CONCLUSION</b>The ESS is an economic and convenient method for screening OSAHS in pregnant women with high diagnostic sensitivity and specificity.</p>