(310) Metanalysis Comparing Screening Methods of Sleep Apnea During Pregnancy

Introduction: Obstructive sleep apnea (OSA), strongly correlates to many maternal comorbidities during pregnancy and literature increasingly demonstrates negative implications for the fetus. The prevalence of OSA ranges from 3%-28%, increasing with gestational age, and maternal impacts range from cardiovascular diseases to gestational diabetes. Initial data indicates OSA is involved in the etiology of fetal growth restriction and other abnormalities. Chronic intermittent maternal hypoxemia from OSA can induce fetal hypoxia. Therefore, it is imperative to improve current screening and early management guidelines for OSA in this population.

Methods: A literature search was performed to compare the current protocols of OSA screening globally and create a more optimized method of recognizing OSA in pregnant women, identifying over 40 research papers. PubMed and Google Scholar were used with the keywords “Obstructive Sleep Apnea”, “Screening” and “Pregnant.” Studies that were not pregnancy focused, lacked clarity on diagnostic tools, and utilized diagnostic technology during screening were excluded.

Results: Current screening methods are based on the nonpregnant population with the understanding that many of these methods are not as accurate for the pregnant population. The STOP-BANG, Berlin Questionnaire, Facco Prediction Model (Facco PM), and the Epworth Sleepiness Scale were the most common questionnaire-based screening methods used to identify risk for OSA. The Facco PM was the most effective for identifying at-risk pregnant women, but lacked specificity. Remaining screening tools were generally ineffective at identifying at-risk participants.

Conclusions:

Conclusion: Diagnosis of OSA in pregnancy has been hindered due to a lack of applicable and reliable screening tools. Currently, the most accurate questionnaire-based screening protocol is the Facco PM. Future plans include optimizing Facco PM as an obstetric screening protocol for OSA to a format that is equitable and accessible for underserved communities.