Association Between Sleep-Disordered Breathing and Hypertensive Disorders of Pregnancy and Gestational Diabetes Mellitus

Purpose of the Review: The main objective of this study is to investigate mechanisms associated with gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) in HIV infected pregnant women by looking how placental hormones such as (progesterone and prolactin) and basic haemostatic parameters are regulated in HIV infected pregnancies.Recent Findings: HIV/AIDS are a major global obstetric health burden that lead to increased rate of morbidity and mortality. HIV/AIDS has been associated with the pathophysiology of GDM and HDP. Increased risk of GDM due to highly active antiretroviral therapy (HAART) usage has been reported in HIV infected pregnancies, which causes insulin resistance in both pregnant and non-pregnant individuals. HAART is a medication used for lowering maternal antepartum viral load and pre-exposure and post-exposure prophylaxis of the infant. In pregnant women, HAART induces diabetogenic effect by causing dysregulation of placental hormones such as (progesterone and prolactin) and predispose HIV infected women to GDM. In addition to HIV/AIDS and GDM, Studies have indicated that HIV infection causes haemostatic abnormalities such as hematological disorder, deregulated haematopoiesis process and the coagulation process which results in HDP.Summary: This study will help on improving therapeutic management and understanding of the pathophysiology of GDM and HDP in the absence as well as in the presence of HIV infection by reviewing studies reporting on these mechanism.

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0436 THE ASSOCIATION BETWEEN GESTATIONAL DIABETES MELLITUS AND SLEEP-DISORDERED BREATHING

SLEEP ◽

10.1093/sleepj/zsx050.435 ◽

2017 ◽

Vol 40 (suppl_1) ◽

pp. A162-A162

Author(s):

B Izci Balserak ◽

G Pien ◽

A Pack ◽

D Mastrogiannis ◽

D Carley ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Sleep Disordered Breathing ◽

Disordered Breathing

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Exploring Fetal Sex as a Risk Factor for Sleep Disordered Breathing and Its Complications in Pregnancy

Gender and the Genome ◽

10.1177/2470289720948076 ◽

2020 ◽

Vol 4 ◽

pp. 247028972094807

Author(s):

Margaret H. Bublitz ◽

Myriam Salameh ◽

Laura Sanapo ◽

Ghada Bourjeily

Keyword(s):

Gestational Diabetes ◽

Pregnancy Complications ◽

Sleep Disordered Breathing ◽

Pregnancy Induced Hypertension ◽

Hypertensive Disorders Of Pregnancy ◽

Fetal Sex ◽

Hypertensive Disorders ◽

Induced Hypertension ◽

In Pregnancy ◽

Disordered Breathing

Sleep disordered breathing (SDB) is a common, yet under-recognized and undertreated condition in pregnancy. Sleep disordered breathing is associated with pregnancy complications including preeclampsia, gestational diabetes, preterm birth, as well as severe maternal morbidity and mortality. The identification of risk factors for SDB in pregnancy may improve screening, diagnosis, and treatment of SDB prior to the onset of pregnancy complications. The goal of this study was to determine whether fetal sex increases risk of SDB in pregnancy. A cohort of singleton (N = 991) pregnant women were recruited within 24 to 48 hours of delivery and answered questions regarding SDB symptoms by questionnaire. Women who reported frequent loud snoring at least 3 times a week were considered to have SDB. Hospital records were reviewed to extract information on fetal sex and pregnancy complications including preeclampsia, pregnancy-induced hypertension, gestational diabetes, preterm delivery, and low birth weight. Women carrying male fetuses were significantly more likely to have SDB (β = .37, P = .01, OR: 1.45 [95% CI: 1.09-1.94]). Fetal sex was associated with increased risk of hypertensive disorders of pregnancy (defined as preeclampsia and/or pregnancy-induced hypertension) among women with SDB in pregnancy (β = .41, P = .02, OR: 1.51 [95% CI: 1.08-2.11]). Fetal sex did not increase risk of preterm birth, low birth weight, or gestational diabetes among women with SDB in pregnancy. Women carrying male fetuses were approximately 1.5 times more likely to report SDB in pregnancy compared to women carrying female fetuses, and women with pregnancy-onset SDB carrying male fetuses were 1.5 times more likely to have hypertensive disorders of pregnancy compared to women with SDB carrying female fetuses. Confirmation of fetal sex as a risk factor may, with other risk factors, play a role in identifying women at highest risk of SDB complications in pregnancy.

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The role of sleep duration and sleep disordered breathing in gestational diabetes mellitus

Neurobiology of Sleep and Circadian Rhythms ◽

10.1016/j.nbscr.2017.11.001 ◽

2018 ◽

Vol 4 ◽

pp. 34-43 ◽

Cited By ~ 6

Author(s):

Joshua J. Gooley ◽

Litali Mohapatra ◽

Derek Chao Kuan Twan

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Sleep Duration ◽

Sleep Disordered Breathing ◽

Disordered Breathing

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Hypertensive disorders of pregnancy in women with gestational diabetes mellitus from Rio de Janeiro, Brazil

Pregnancy Hypertension ◽

10.1016/j.preghy.2017.08.006 ◽

2017 ◽

Vol 10 ◽

pp. 196-201 ◽

Cited By ~ 3

Author(s):

Luciana Lourenço Gomes dos Santos da Silva ◽

Cláudia Saunders ◽

Aline Bull Ferreira Campos ◽

Gabriella Pinto Belfort ◽

Patricia de Carvalho Padilha ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Rio De Janeiro ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

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Population-based study on birth outcomes among women with hypertensive disorders of pregnancy and gestational diabetes mellitus

Scientific Reports ◽

10.1038/s41598-021-96345-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ya-Wen Lin ◽

Ming-Hung Lin ◽

Lee-Wen Pai ◽

Jen-Wei Fang ◽

Chih-Hsin Mou ◽

...

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Birth Outcomes ◽

Ductus Arteriosus ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Adverse Neonatal Outcomes

AbstractTo evaluate birth outcomes in women with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), we used insurance data of Taiwan to evaluate 11 adverse neonatal outcomes of infants born to women with HDP (N = 7775) and with both HDP and GDM (HDP/GDM) (N = 1946), comparing to women with neither disorder (N = 19,442), matched by age. The impacts of preeclampsia/eclampsia were also evaluated. Results showed that Caesarean section delivery was near 1.7-fold greater in the HDP/GDM and HDP groups than in comparisons. The preterm delivery rates were more than threefold greater in HDP/GDM group and HDP group than in comparisons with adjusted odds ratios (aORs) of 4.84 (95% confidence interval (CI) 4.34–5.40) and 3.92 (95% CI 3.65–4.21), respectively, followed by jaundice (aORs 2.95 (95% CI 2.63–3.33) and 1.90 (95% CI 1.76–2.06)), and small gestation age (SGA) (aORs 6.57 (95% CI 5.56–7.75) and 5.81 (95% CI 5.15–6.55)). Incidence rates of birth trauma, patent ductus arteriosus, atrial septal defect, respiratory distress syndrome, and neonatal hypoglycemia were also higher in the HDP/GDM and HDP groups than in the comparison group. Most adverse outcomes increased further in women with preeclampsia or eclampsia. In conclusion, women with HDP are at elevated risks of adverse neonatal outcomes. Risks of most adverse outcomes increase further for women with both HDP and GDM. Preeclampsia or eclampsia may also contribute to these outcomes to higher risk levels. Every pregnant woman with these conditions deserves specialized prenatal care.

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