A systematic review and quantitative assessment of sleep-disordered breathing during pregnancy and perinatal outcomes

Purpose Previous investigations have suggested a strong association between sleep-disordered breathing (SDB) during pregnancy and perinatal outcomes. However, the results of the following replication studies were not always concordant. Therefore, this meta-analysis was conducted to evaluate the more...

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Veröffentlicht in:Sleep & breathing 2014-12, Vol.18 (4), p.703-713
Hauptverfasser: Ding, Xiu-Xiu, Wu, Yi-Le, Xu, Shao-Jun, Zhang, Shi-Fen, Jia, Xiao-Min, Zhu, Ruo-Ping, Hao, Jia-Hu, Tao, Fang-Biao
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container_end_page 713
container_issue 4
container_start_page 703
container_title Sleep & breathing
container_volume 18
creator Ding, Xiu-Xiu
Wu, Yi-Le
Xu, Shao-Jun
Zhang, Shi-Fen
Jia, Xiao-Min
Zhu, Ruo-Ping
Hao, Jia-Hu
Tao, Fang-Biao
description Purpose Previous investigations have suggested a strong association between sleep-disordered breathing (SDB) during pregnancy and perinatal outcomes. However, the results of the following replication studies were not always concordant. Therefore, this meta-analysis was conducted to evaluate the more reliable estimate. Methods A systematic literature search was performed on PubMed, Springer Link, and EMBASE to identify all eligible studies published before August 2013. Summary odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using fixed or random effects model. Results A total of 24 publications met the inclusion criteria and were included in this meta-analysis. Findings demonstrated that moderate-to-severe SDB during pregnancy was associated with gestational diabetes mellitus (OR = 1.78; 95 % CI, 1.29 to 2.46), pregnancy-related hypertension (OR = 2.38; 95 % CI, 1.63 to 3.47), preeclampsia (OR = 2.19; 95 % CI, 1.71 to 2.80), preterm delivery (OR = 1.98; 95 % CI, 1.59 to 2.48), low birth weight (OR = 1.75; 95 % CI, 1.33 to 2.32), neonatal intensive care unit (NICU) admission (OR = 2.43; 95 % CI, 1.61 to 3.68), intrauterine growth restriction (OR = 1.44; 95 % CI, 1.22 to 1.71), and Apgar score of
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However, the results of the following replication studies were not always concordant. Therefore, this meta-analysis was conducted to evaluate the more reliable estimate. Methods A systematic literature search was performed on PubMed, Springer Link, and EMBASE to identify all eligible studies published before August 2013. Summary odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using fixed or random effects model. Results A total of 24 publications met the inclusion criteria and were included in this meta-analysis. Findings demonstrated that moderate-to-severe SDB during pregnancy was associated with gestational diabetes mellitus (OR = 1.78; 95 % CI, 1.29 to 2.46), pregnancy-related hypertension (OR = 2.38; 95 % CI, 1.63 to 3.47), preeclampsia (OR = 2.19; 95 % CI, 1.71 to 2.80), preterm delivery (OR = 1.98; 95 % CI, 1.59 to 2.48), low birth weight (OR = 1.75; 95 % CI, 1.33 to 2.32), neonatal intensive care unit (NICU) admission (OR = 2.43; 95 % CI, 1.61 to 3.68), intrauterine growth restriction (OR = 1.44; 95 % CI, 1.22 to 1.71), and Apgar score of &lt;7 at 1 min (OR = 1.78; 95 % CI, 1.10 to 2.91) based on all studies but not gestational age and birth weight. Conclusions This meta-analysis revealed that moderate-to-severe SDB during pregnancy may be associated with most of adverse perinatal outcomes. Further well-designed studies are warranted to confirm our findings.</description><identifier>ISSN: 1520-9512</identifier><identifier>EISSN: 1522-1709</identifier><identifier>DOI: 10.1007/s11325-014-0946-4</identifier><identifier>PMID: 24519711</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Apgar Score ; Biological and medical sciences ; Dentistry ; Diabetes ; Diabetes, Gestational - diagnosis ; Diseases of mother, fetus and pregnancy ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Female ; Fetal Growth Retardation - diagnosis ; Fundamental and applied biological sciences. Psychology ; Gynecology. Andrology. Obstetrics ; Humans ; Hypertension, Pregnancy-Induced - diagnosis ; Infant, Low Birth Weight ; Infant, Newborn ; Internal Medicine ; Maternal &amp; child health ; Medical sciences ; Medicine ; Medicine &amp; Public Health ; Meta-analysis ; Nervous system (semeiology, syndromes) ; Neurology ; Obstetric Labor, Premature - diagnosis ; Otorhinolaryngology ; Pediatrics ; Pneumology ; Pneumology/Respiratory System ; Preeclampsia ; Pregnancy ; Pregnancy Complications - diagnosis ; Pregnancy Outcome ; Pregnancy. Fetus. Placenta ; Respiratory system : syndromes and miscellaneous diseases ; Review ; Risk Factors ; Sleep Apnea, Obstructive - diagnosis ; Sleep disorders ; Sleep. 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However, the results of the following replication studies were not always concordant. Therefore, this meta-analysis was conducted to evaluate the more reliable estimate. Methods A systematic literature search was performed on PubMed, Springer Link, and EMBASE to identify all eligible studies published before August 2013. Summary odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using fixed or random effects model. Results A total of 24 publications met the inclusion criteria and were included in this meta-analysis. Findings demonstrated that moderate-to-severe SDB during pregnancy was associated with gestational diabetes mellitus (OR = 1.78; 95 % CI, 1.29 to 2.46), pregnancy-related hypertension (OR = 2.38; 95 % CI, 1.63 to 3.47), preeclampsia (OR = 2.19; 95 % CI, 1.71 to 2.80), preterm delivery (OR = 1.98; 95 % CI, 1.59 to 2.48), low birth weight (OR = 1.75; 95 % CI, 1.33 to 2.32), neonatal intensive care unit (NICU) admission (OR = 2.43; 95 % CI, 1.61 to 3.68), intrauterine growth restriction (OR = 1.44; 95 % CI, 1.22 to 1.71), and Apgar score of &lt;7 at 1 min (OR = 1.78; 95 % CI, 1.10 to 2.91) based on all studies but not gestational age and birth weight. Conclusions This meta-analysis revealed that moderate-to-severe SDB during pregnancy may be associated with most of adverse perinatal outcomes. Further well-designed studies are warranted to confirm our findings.</description><subject>Apgar Score</subject><subject>Biological and medical sciences</subject><subject>Dentistry</subject><subject>Diabetes</subject><subject>Diabetes, Gestational - diagnosis</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</subject><subject>Female</subject><subject>Fetal Growth Retardation - diagnosis</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Hypertension, Pregnancy-Induced - diagnosis</subject><subject>Infant, Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Internal Medicine</subject><subject>Maternal &amp; child health</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Meta-analysis</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Obstetric Labor, Premature - diagnosis</subject><subject>Otorhinolaryngology</subject><subject>Pediatrics</subject><subject>Pneumology</subject><subject>Pneumology/Respiratory System</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - diagnosis</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Review</subject><subject>Risk Factors</subject><subject>Sleep Apnea, Obstructive - diagnosis</subject><subject>Sleep disorders</subject><subject>Sleep. 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Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</topic><topic>Female</topic><topic>Fetal Growth Retardation - diagnosis</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Hypertension, Pregnancy-Induced - diagnosis</topic><topic>Infant, Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Internal Medicine</topic><topic>Maternal &amp; child health</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Meta-analysis</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Obstetric Labor, Premature - diagnosis</topic><topic>Otorhinolaryngology</topic><topic>Pediatrics</topic><topic>Pneumology</topic><topic>Pneumology/Respiratory System</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - diagnosis</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Review</topic><topic>Risk Factors</topic><topic>Sleep Apnea, Obstructive - diagnosis</topic><topic>Sleep disorders</topic><topic>Sleep. Vigilance</topic><topic>Systematic review</topic><topic>Vertebrates: nervous system and sense organs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ding, Xiu-Xiu</creatorcontrib><creatorcontrib>Wu, Yi-Le</creatorcontrib><creatorcontrib>Xu, Shao-Jun</creatorcontrib><creatorcontrib>Zhang, Shi-Fen</creatorcontrib><creatorcontrib>Jia, Xiao-Min</creatorcontrib><creatorcontrib>Zhu, Ruo-Ping</creatorcontrib><creatorcontrib>Hao, Jia-Hu</creatorcontrib><creatorcontrib>Tao, Fang-Biao</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Social Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep &amp; breathing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ding, Xiu-Xiu</au><au>Wu, Yi-Le</au><au>Xu, Shao-Jun</au><au>Zhang, Shi-Fen</au><au>Jia, Xiao-Min</au><au>Zhu, Ruo-Ping</au><au>Hao, Jia-Hu</au><au>Tao, Fang-Biao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A systematic review and quantitative assessment of sleep-disordered breathing during pregnancy and perinatal outcomes</atitle><jtitle>Sleep &amp; breathing</jtitle><stitle>Sleep Breath</stitle><addtitle>Sleep Breath</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>18</volume><issue>4</issue><spage>703</spage><epage>713</epage><pages>703-713</pages><issn>1520-9512</issn><eissn>1522-1709</eissn><abstract>Purpose Previous investigations have suggested a strong association between sleep-disordered breathing (SDB) during pregnancy and perinatal outcomes. However, the results of the following replication studies were not always concordant. Therefore, this meta-analysis was conducted to evaluate the more reliable estimate. Methods A systematic literature search was performed on PubMed, Springer Link, and EMBASE to identify all eligible studies published before August 2013. Summary odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using fixed or random effects model. Results A total of 24 publications met the inclusion criteria and were included in this meta-analysis. Findings demonstrated that moderate-to-severe SDB during pregnancy was associated with gestational diabetes mellitus (OR = 1.78; 95 % CI, 1.29 to 2.46), pregnancy-related hypertension (OR = 2.38; 95 % CI, 1.63 to 3.47), preeclampsia (OR = 2.19; 95 % CI, 1.71 to 2.80), preterm delivery (OR = 1.98; 95 % CI, 1.59 to 2.48), low birth weight (OR = 1.75; 95 % CI, 1.33 to 2.32), neonatal intensive care unit (NICU) admission (OR = 2.43; 95 % CI, 1.61 to 3.68), intrauterine growth restriction (OR = 1.44; 95 % CI, 1.22 to 1.71), and Apgar score of &lt;7 at 1 min (OR = 1.78; 95 % CI, 1.10 to 2.91) based on all studies but not gestational age and birth weight. Conclusions This meta-analysis revealed that moderate-to-severe SDB during pregnancy may be associated with most of adverse perinatal outcomes. Further well-designed studies are warranted to confirm our findings.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24519711</pmid><doi>10.1007/s11325-014-0946-4</doi><tpages>11</tpages></addata></record>
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subjects Apgar Score
Biological and medical sciences
Dentistry
Diabetes
Diabetes, Gestational - diagnosis
Diseases of mother, fetus and pregnancy
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Female
Fetal Growth Retardation - diagnosis
Fundamental and applied biological sciences. Psychology
Gynecology. Andrology. Obstetrics
Humans
Hypertension, Pregnancy-Induced - diagnosis
Infant, Low Birth Weight
Infant, Newborn
Internal Medicine
Maternal & child health
Medical sciences
Medicine
Medicine & Public Health
Meta-analysis
Nervous system (semeiology, syndromes)
Neurology
Obstetric Labor, Premature - diagnosis
Otorhinolaryngology
Pediatrics
Pneumology
Pneumology/Respiratory System
Preeclampsia
Pregnancy
Pregnancy Complications - diagnosis
Pregnancy Outcome
Pregnancy. Fetus. Placenta
Respiratory system : syndromes and miscellaneous diseases
Review
Risk Factors
Sleep Apnea, Obstructive - diagnosis
Sleep disorders
Sleep. Vigilance
Systematic review
Vertebrates: nervous system and sense organs
title A systematic review and quantitative assessment of sleep-disordered breathing during pregnancy and perinatal outcomes
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