The Association Between High Risk Pregnancy and Sleep-disordered Breathing
The Association Between High Risk Pregnancy and Sleep-disordered Breathing
The aim of the present study is to establish, using polysomnographic criteria and prospective
 nature, whether sleep apnea in pregnancy is more prevalent in women with high risk
 pregnancies including preeclampsia, gestational diabetes, and pre-mature contractions, and to
 determine the effect of sleep disordered breathing in pregnancy on fetal outcome. The
 investigators' hypothesis is that sleep-disordered breathing is more prevalent in women with
 high risk pregnancy compared to those with uncomplicated pregnancy.
Over the last decade, the association between sleep disordered breathing and pregnancy
 outcome has been described primarily in case reports. Although recently, larger studies
 describing adverse pregnancy outcomes in women with sleep disordered breathing has begun to
 emerge, these studies often lack polysomnographic data and the true prevalence of sleep
 disordered breathing in pregnancy is not known. We intend to recruit 100 women at the third
 trimester of pregnancy, who are admitted to the high risk pregnancy unit with pre-eclampsia,
 gestational diabetes, or premature labor. An additional group of 50 women at the third
 trimester of an uncomplicated pregnancy will be recruited. All women will fill questionnaires
 regarding the pregnancy and their sleep and will undergo an overnight sleep study. Women will
 then be followed until birth. Pregnancy complication, birth and perinatal course will be
 recorded. Cord blood will be collected from all infants and evaluated for inflammatory
 cytokines, reactive oxygen species and growth factors. Infants will then be followed for 1
 year. Their growth, development and intercurrent illnesses will be recorded.
Inclusion Criteria:

 -  Age 19 - 39 years

 -  Over 26 weeks of gestation

 -  One of the following:

 1. Pre-eclampsia defined as systolic blood pressure > 140 or diastolic blood
 pressure > 90 and associated proteinuria > 300 mg / 24 h urine collection.

 2. Gestational diabetes requiring insulin treatment

 3. Premature contractions with associated cervical dilation or effacement

 4. Uncomplicated pregnancy

 Exclusion Criteria:

 -  Chronic maternal disease

 -  Alcohol consumption during pregnancy

 -  Illicit drug abuse at any time in life

 -  Fetal abnormalities on obstetric ultrasound