Prevalence of components of metabolic syndrome in pregnant women with obstructive sleep apnoea hypopnoea syndrome
Keywords:Metabolic syndrome, OSAHS, Polysomnography, Third trimester pregnancy
Background: Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) related cardiovascular and metabolic risk factors such as hypertension, diabetes mellitus and dyslipidaemia which together are commonly known as metabolic syndrome (MS) is often overlooked in pregnancy. OSAHS is known to cause higher maternal morbidity and bad foetal outcome. Aim was to study the prevalence of components of MS among third trimester pregnant women with OSAHS.
Methods: A total of 100 cases and 100 controls each amongst third trimester pregnant females admitted in the Department of Obstetrics and Gynecology at the Government Medical College, Kozhikode, Kerala, India were enrolled in the study. All subjects underwent a thorough clinical, anthropometric, obstetrical examination and biochemical tests such as complete blood count, blood sugar and lipid profile. The parameters were compared between cases and controls.
Results: OSAHS positive pregnant women had a higher prevalence of elevated systolic (P=0.01) and diastolic (P=0.002) blood pressure, abnormal fasting (P<0.0001) and post prandial (P=0.02) blood sugar, abnormal cholesterol (P=0.006) and triglyceride levels (P<0.001), and abnormally low HDL levels (P<0.001).
Conclusions: This study showed that metabolic syndrome was highly prevalent among OSAHS positive third trimester pregnancy (52%) versus OSAHS negative (8%) pregnant women.
Angelico F, Ben MD, Augelletti T, De Vita R, Roma R, Violi F, et al. Obstructive sleep apnoea syndrome and the metabolic syndrome in an internal medicine setting. Eur J Intern Med. 2010;21:191-5.
McDade C, Duree KH, Griffin SC, Weatherly HLA, Stradling JR, Davies RJO, et al. A systemic review of continuous positive airway pressure for obstructive sleep apnoea-hypopnoea syndrome. Sleep Med Rev. 2009;13:427-36.
Villaneuva ATC, Buchanan PR, Yee BJ, Grunstein RR. Ethnicity and obstructive sleep apnoea. Sleep Med Rev. 2005;9:419-36.
Pataka A, Riha RL. The obstructive sleep apnoea/hypopnoea syndrome- An overview. Respiratory Med CME. 2009;2:111-7.
Pepperell JCT, Davies RJO, Stradling JR. Systemic hypertension and obstructive sleep apnoea. Sleep Med Rev 2002;6:157-73.
Labaan JP, Mounier L, Orbcastel OR, Veale D, Blacher J, Melloni B, et al. Cardiovascular risk factors in men and women with obstructive sleep apnoea syndrome. Respiratory Med. 2010;104:1063-8.
Negrato CA, Jovanovic L, Rafacho A, Tambascia MA, Geloneze B, Dias A, et al. Association between different levels of dysglycemia and metabolic syndrome in pregnancy. Diabetol Metab Syndr. 2009;1(3):1-6.
Punjabi NM. The epidemiology of adult obstructive sleep apnoea. Proc Am Thorac Soc. 2008;5:136-43.
Lavie P. Who was the first to use the term Pickwickian in connection with sleepy patients? History of sleep apnoea syndrome. Sleep Med Rev. 2008;12:5-17.
Obstructive sleep apnoea syndrome- a systemic review. A joint Nordic project. Jerhammar and Co., Norrkoping, Sweden. 2007.
Lam JCM, Mak JCW, Mary SM. Obesity, obstructive sleep apnoea and metabolic syndrome. Respirology. 2012;17:223-36.
Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnoea-a population health perspective. Am J Respir Crit Care Med. 2002;165:1217-39.
Tasali E, Mari SM. Obstructive sleep apnoea and metabolic syndrome-alterations in glucose metabolism and inflammation. Proc A Thorac Soc. 2008;5:207-17.
Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, Islam S, et al. Validity of Berlin Questionnaire and American Society of Anaesthesiologists Checklist as screening tools for Obstructive Sleep Apnoea in Surgical patients. Anesthesiology. 2008;108:822-30.
Champagne KA, Kimoff JR, Barriga PC, Schwartzman K. Sleep disordered breathing in women of child bearing age during pregnancy. Indian J Med Res. 2010;131:285-301.
Schwartz AR, Patil SP, Laffan AM, Polotsky V, Schneider H, Smith PL. Obesity and Obstructive Sleep Apnoea. Proc Am Thorac Soc. 2008;5:185-92.
Metabolic Syndrome- The IDF consensus worldwide definition of the Metabolic Syndrome. International Diabetic Federation. 2006.
Richadson P. Sleep in pregnancy. Holistic Nurs Pract. 1996;10(4):20-6.
Sahota PK, Jain SS, Dhand R. Sleep disorders in pregnancy. Curr Opin Pulmonary Med. 2003;9:477-83.
Santiago JR, Nolledo MS, Kinzler W, Santiago TV. Sleep and Sleep Disorders in Pregnancy. Ann Intern Med. 2001;134:396-408.
Kipsimalis F, Kryger M. Obstructive Sleep Apnoea in Pregnancy. Sleep Med Clin. 2007;2:603-13.
Riha RL, Defenbach K, Jennum P, McNicholas WT. Genetic aspects of hypertension and metabolic disease in the obstructive sleep apnoea-hypopnoea syndrome. Sleep Med Rev. 2008;12:46-63.
Edwards N, Middleton PG, Blyton DM, Sullivan CE. Sleep disordered breathing and pregnancy. Thorax. 2002;57:555-8.
Louis JM, Auckley D, Sokol RJ, Mercer BM. Maternal and neonatal morbidities associated with obstructive sleep apnoea complicating pregnancy. Am J Obstet Gynecol. 2010;202:261e1-5.
Sharma S, Franco R. Sleep and its disorders in pregnancy. Wisconsin Med J. 2004;103(5):48-52.
Thiruvagounder M, Khan S, Sheriff DS. Prevalence of metabolic syndrome in a local population in India. Biochemia Medica. 2010;20(2):249-52.
Catalano PM. Obesity, insulin resistance and pregnancy outcome. Reproduction. 2010;140:365-71.
Isezou SA, Ekele BA. Comparison of metabolic syndrome variables among pregnant women with and without eclampsia. J Nat Med Assoc. 2008;100:1059-62.
Venkata C, Venkateshiah SB. Sleep disordered breathing during pregnancy. J Am Board Fam Med. 2009;22:158-68.
Roche F, Sforza E, Pichot V, Maudoux D, Garcin A, Celle S, et al. Obstructive sleep apnoea/hypopnea influences high-density lipoprotein cholesterol in the elderly. Sleep Med. 2009;8:882-6.