High prevalence of obstructive sleep apnea in pregnant women with class III obesity: a prospective cohort study

Emma C. Johns, Elizabeth A. Hill, Williams Ba Stevie, Abdelkebir Sabil, Renata L. Riha, Fiona C. Denison, Rebecca M. Reynolds*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Study Objectives: To determine the prevalence of obstructive sleep apnea (OSA) in a cohort of women with class III obesity, and a comparator lean group, in the second and third trimesters of pregnancy. Secondary objectives were to compare characteristics of obese women with and without OSA, and to assess factors which were predictive of OSA.

Methods: We performed a prospective cohort study involving 33 women with class III obesity (mean body mass index [BMI] 43.5±3.9kg/m2) and 39 lean women (BMI 22.0±1.7kg/m2) with singleton pregnancies. Participants completed two level 3 sleep studies between 12-22 weeks’ and 32-38 weeks’ gestation. OSA was defined as a respiratory event index ≥5 (≥3% desaturation criteria). Levels of interleukin 6, glucose and C-peptide were quantified in maternal blood. Logistic regression analysis was performed to determine predictors of OSA.

Results: OSA was identified in 12 (37.5%) and 14 (50.0%) obese women, and in 1 (2.6%) and 3 (9.1%) lean women, in the second and third trimesters, respectively. Obese women with OSA were older than those with no OSA but otherwise had similar characteristics. In unadjusted analysis of obese women, increased age, BMI, and Homeostatic Model Assessment of Insulin Resistance, and history of non-smoking were associated with increased odds of OSA. In multivariable analysis, only increased age remained significantly associated with OSA.

Conclusions: OSA is highly prevalent in pregnant women with class III obesity. Further research is required to establish effective management strategies for the growing number of women in this high-risk group.
Original languageEnglish
JournalJournal of clinical sleep medicine
Publication statusPublished - 5 Aug 2021


  • Obstructive sleep apnea
  • pregnancy
  • Obesity


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