Infants born to mothers with sleep-disordered breathing—snoring, apnea, and other breathing difficulties during sleep—are more likely to develop complications such as jaundice, low blood sugar, seizures, or death during the newborn period, suggests a study funded by the National Institutes of Health. The authors called for studies to determine if treating mid-pregnancy, sleep-disordered breathing would improve infant outcomes.
The current study was conducted by Arlin Delgado, M.D., of the University of South Florida, and colleagues at academic centers throughout the United States. It appears in the American Journal of Perinatology. Funding was provided by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Heart, Lung, and Blood Institute.
Sleep-disordered breathing occurs in an estimated 11 to 20% of pregnant individuals. The most common form of sleep-disordered breathing is obstructive sleep apnea, which occurs when the upper airway becomes blocked many times during sleep, reducing or completely stopping airflow. In pregnancy, sleep-disordered breathing is associated with a higher risk of gestational diabetes and high blood pressure disorders.
Few studies have been conducted on how sleep-disordered breathing may affect newborn outcomes, and those studies that have been conducted have been small and produced inconsistent results.
For the current study, the researchers analyzed overnight, at-home sleep monitoring data collected from roughly 2,100 individuals in a larger study on two separate occasions—once in early pregnancy (6 to 12 weeks) and again in mid-pregnancy (22 to 31 weeks).
Mothers were considered to have sleep-disordered breathing if they had five or more instances of periodic breathing cessation or slowed breathing on either night.
Infants were classified as experiencing complications if they had either respiratory distress syndrome (a lung condition affecting newborns), transient tachypnea (temporary rapid breathing), required respiratory support, were treated for newborn jaundice or low blood sugar, were large for their gestational age, had seizures, had sepsis (inflammation throughout the body triggered by an infection), or died.
Among the participants, 3% had sleep-disordered breathing in early pregnancy, and 5.7% developed sleep-disordered breathing in mid-pregnancy. Complications occurred in 29.3% of infants in the early pregnancy group, 30.3% of infants of the mid-pregnancy group, and in 17.8% of infants of individuals who did not have sleep-disordered breathing.
However, when the researchers statistically compensated for factors associated with sleep-disordered breathing, such as high blood pressure, pregestational diabetes, and obesity, infants of mothers in the early pregnancy group had no greater risk for complications than infants of mothers without sleep-disordered breathing. However, infants of mothers in the mid-pregnancy group had a 42% higher risk of complications than infants of mothers without sleep-disordered breathing.
The authors concluded that maternal sleep-disordered breathing that develops in mid-pregnancy is associated with a higher risk of adverse newborn outcomes.
Studying the association between sleep-disordered breathing in mid-pregnancy and adverse newborn outcomes will provide information that clinicians can use to guide and counsel patients, the authors wrote. They called for additional research to understand factors leading up to the development of sleep-disordered breathing in mid-pregnancy and studies to determine if treating sleep-disordered breathing improves newborn outcomes.
Delgado, A., et al. Association between sleep disordered breathing and neonatal outcomes in nulliparous individuals. American Journal of Perinatology. 2023.