The Relationship between Snoring and Preeclampsia: A Case-Control Study
Background and Objective: The prevalence of snoring and sleepiness increases during pregnancy and affects maternal health and pregnancy outcomes. Therefore, this study was conducted to assess the association between snoring during pregnancy and the risk of preeclampsia.
Materials and Methods: This case-control study was performed among 150 pregnant women with preeclampsia and 150 healthy women referred to health centers and academic hospitals of Mashhad, Iran. Data collection tools included the information form regarding demographic characteristics, clinical signs, and laboratory findings. To evaluate snoring and its severity, the related question in Pittsburgh Sleep Quality Index (PSQI) was applied. Statistical analysis of data was performed by independent t-test, Mann-Whitney, chi-square test, and logistic regression model.
Results: There was significant association between snoring and preeclampsia (P < 0.001), so that the mean and standard deviation (SD) of snoring (Likert Scale of 0-3) in patients with preeclampsia was 0.6 ± 1.1, and in nonpreeclamptic women was 0.4 ± 0.9. The chance of preeclampsia in women with snoring was 1.73 times more than those without snoring [Odds ratio (OR) = 1.73, confidence interval (CI) 95%: 1.29-2.25].
Conclusion: Snoring is a predicting factor of preeclampsia. Thus, midwives and health workers' attention during pregnancy is recommended.
James D, Steer P, Weiner C, et al. High risk pregnancy. Philadelphia, PA: Saunders; 2010.
Ghare Khani P, Sadatian SA. Basics of pregnancy and childbirth. Tehran, Iran: Nour Danesh Publications; 2002. [In Persian].
Roberts JM. Endothelial dysfunction in preeclampsia. Semin Reprod Endocrinol 1998; 16: 5-15.
Alebiosu OC, Ogunsemi OO, Familoni OB, et al. Quality of sleep among hypertensive patients in a semi-urban Nigerian community: A prospective study. Postgrad Med 2009; 121: 166-72.
Knutson KL, Van Cauter E, Rathouz PJ, et al. Association between sleep and blood pressure in midlife: The cardia sleep study. Arch Intern Med 2009; 169: 1055-61.
O'Brien LM, Bullough AS, Owusu JT, et al. Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: Prospective cohort study. Am J Obstet Gynecol 2012; 207: 487-9.
Ebuehi O, Osagie OG, Ebuehi OM, et al. Oxidative stress during the various trimesters of pregnancy in humans. Nigerian Journal of Health and Biomedical Sciences 2003; 2: 61-4.
Amir Ali Akbari S, Bolouri B, Sadegh Niat Haghighi KH, et al. Relation between sleep disorders in the last month of pregnancy and type of delivery in women referring to health centers at Saghez. J Nurs Midwifery Shahid Beheshti Univ Med Sci 2006; 16: 35-42. [In Persian].
Gislason T, Benediktsdottir B, Bjornsson JK, et al. Snoring, hypertension, and the sleep apnea syndrome. An epidemiologic survey of middle-aged women. Chest 1993; 103: 1147-51.
Loube DI, Poceta JS, Morales MC, et al. Selfreported snoring in pregnancy. Association with fetal outcome. Chest 1996; 109: 885-9
Ursavas A, Karadag M, Nalci N, et al. Selfreported snoring, maternal obesity and neck circumference as risk factors for pregnancy-induced hypertension and preeclampsia. Respiration 2008; 76: 33-9.
Houyez F, Degoulet P, Cittee J, et al. Sleep and hypertension. An epidemiologic study in 7,901 workers. Arch Mal Coeur Vaiss 1990; 83: 1085-8.
Ayrim A, Keskin EA, Ozol D, et al. Influence of self-reported snoring and witnessed sleep apnea on gestational hypertension and fetal outcome in pregnancy. Arch Gynecol Obstet 2011; 283: 195-9. 14. Edwards N, Middleton PG, Blyton DM, et al. Sleep disordered breathing and pregnancy. Thorax 2002; 57: 555-8.
Lee KA, Caughey AB. Evaluating insomnia during pregnancy and postpartum. In: Attarian HP, Editor. Sleep disorders in women: From menarche through pregnancy to menopause: A guide for practical management. New York, NY: Humana Press; 2006. p. 185-98.
Franklin KA, Holmgren PA, Jonsson F, et al. Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. Chest 2000; 117: 137-41.
Izci B, Vennelle M, Liston WA, et al. Sleepdisordered breathing and upper airway size in pregnancy and post-partum. Eur Respir J 2006; 27: 321-7.
Reza H, Kian N, Pouresmail Z, et al. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Complement Ther Clin Pract 2010; 16: 81-5.
Sahota PK, Jain SS, Dhand R. Sleep disorders in pregnancy. Curr Opin Pulm Med 2003; 9: 477-83.
Nazarpour S. Sleep disorders in pregnancy and its effect on the length of the labor and type of delivery in Firuzabadi Hospital in Tehran in 2006. Iran J Nurs 2007; 20: 63-73. [In Persian].