Sleep-related breathing disorders during pregnancy: A systematic review and meta-analysis
Valentina Poletti, Sandra Hackethal, Anna Castelnovo, Silvia Riccardi, Eleonora Volpato, Mauro Manconi
Abstract
This systematic review analyzed 37 studies on sleep-disordered breathing during pregnancy, involving over 7000 women, predominantly pregnant, with a subgroup of non-pregnant controls. Most studies were conducted in the United States, using in-laboratory polysomnography and focusing on the third trimester. The meta-analysis estimated a prevalence of nearly 20 %, although results showed considerable heterogeneity, reflecting variations in study methodologies, diagnostic criteria, and sample characteristics. Sleep-disordered breathing was generally mild, with body mass index identified as the main risk factor, while age did not appear to significantly influence prevalence. Monitoring body mass index throughout pregnancy and screening for sleep-disordered breathing in women with gestational diabetes or hypertensive disorders is crucial, as these conditions are associated with higher prevalence. Findings highlight the need for future studies to adhere to standardized guidelines, use objective diagnostic tools, and include larger, well-characterized samples of normal pregnancies. Comparative studies with matched non-pregnant controls by body mass index and age, longitudinal cohort designs, and interventional trials using continuous positive airway pressure for moderate-to-severe obstructive sleep apnea are essential to enhance understanding and improve maternal-fetal outcomes.