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Screening methods for obstructive sleep apnoea in severely obese pregnant women

Abayomi, JC and Charnley, MS and Longworth, H and McCallin, K and Narayanan, RP and Turner, MA and Quenby, S and Ryecroft, D and Topping, J and Wilding, J and Weeks, A (2017) Screening methods for obstructive sleep apnoea in severely obese pregnant women. Clinical Obesity, 7 (4). pp. 239-244. ISSN 1758-8103

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Abstract

Obstructive sleep apnoea (OSA) is an often-overlooked diagnosis, more prevalent in the obese population. Screening method accuracy, uptake and hence diagnosis is variable. There is limited data available regarding the obese pregnant population; however, many studies highlight potential risks of apnoeic episodes to mother and foetus, including hypertension, diabetes and preeclampsia. A total of 162 women with a body mass index (BMI) ≥ 35 were recruited from a tertiary referral hospital in the northwest of England. They were invited to attend three research antenatal clinics, completing an Epworth Sleepiness Scale (ESS) questionnaire at each visit. A monitor measuring the apnoea hypopnoea index (AHI) was offered at the second visit. Data taken from consent forms, hospital notes and hospital computer records were collated and anonymized prior to statistical analysis. A total of 12.1% of women had an ESS score of >10, suggesting possible OSA. Rates increased throughout pregnancy, although unfortunately, the attrition rate was high; 29.0% of women used the RUSleeping (RUS) meter, and only one (2.1%) met pre-specified criteria for OSA (AHI ≥ 15). This individual had OSA categorized as severe and underwent investigations for preeclampsia, eventually delivering by emergency caesarean section due to foetal distress. The accuracy of the ESS questionnaire, particularly the RUS monitor, to screen for OSA in the pregnant population remains unclear. Further research on a larger sample size using more user-friendly technology to confidently measure AHI would be beneficial. There are currently no guidelines regarding screening for OSA in the obese pregnant population, yet risks to both mother and foetus are well researched.

Item Type: Article
Additional Information: This is the accepted version of the following article: Longworth, H., McCallin, K., Narayanan, R. P., Turner, M. A., Quenby, S., Rycroft, D., Charnley, M., Abayomi, J., Topping, J., Weeks, A. D. and Wilding, J. P. H. (2017), Screening methods for obstructive sleep apnoea in severely obese pregnant women. Clin Obes, 7: 239–244. doi:10.1111/cob.12196, which has been published in final form at http://dx.doi.org/10.1111/cob.12196
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: School of Sport Studies, Leisure and Nutrition
Publisher: Wiley
Date Deposited: 14 Jul 2017 08:10
Last Modified: 22 Sep 2017 14:10
DOI or Identification number: 10.1111/cob.12196
URI: http://researchonline.ljmu.ac.uk/id/eprint/6821

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