scholarly journals OR10-01 Mild Maternal Sleep Disordered Breathing in Pregnant Women Affects Growth Patterns of Head Circumference and Adiposity During the First Three Years of Life

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Avivit Brener ◽  
Yael Lebenthal ◽  
Sigal Levy ◽  
Galit Levi Dunietz ◽  
Orna Sever ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Head Circumference ◽  
Sleep Disordered Breathing ◽  
Growth Patterns ◽  
Distinctive Pattern ◽  
Third Trimester ◽  
Sleep Study ◽  
The Third ◽  
Study Results ◽  
Disordered Breathing

Abstract Background The intrauterine environment affects growth and adiposity acquisition from the fetal period until adulthood. Mild sleep disordered breathing (SDB) during pregnancy is a common underdiagnosed medical condition in healthy women. We aimed to investigate the interaction between maternal isolated SDB during the third trimester of pregnancy and the offspring’s growth and adiposity during the first three years of life. Methods Healthy pregnant women in the third trimester of an uncomplicated singleton pregnancy who were followed at the low-risk obstetric surveillance clinic of our hospital were recruited between 4/2013 and 5/2016. They were followed from enrollment until their offspring was three years old. During their third trimester of pregnancy, they underwent an ambulatory overnight sleep study by means of a validated sleep technology [SDB defined as apnea hypopnea index (AHI) ≥5]. Fasting blood samples were drawn on the following morning for glucose, insulin, HbA1c, lipid profile and C-reactive protein (CRP) levels. The offspring’s growth (length, weight and head circumference) and adiposity (subscapular and triceps skinfolds) parameters were measured at birth, 1 and 4 months, and 1, 2, and 3 years of age. Growth parameters were presented as standard deviation scores using the CDC growth charts. A general linear model was used to evaluate the interaction between maternal SDB and her offspring’s growth and adiposity measurements, after controlling for gestational week at delivery and maternal and paternal body mass index (BMI). Results Fourteen of 58 women (24.1%) were diagnosed with SDB (AHI range 5.3–14.7). They had a significantly higher mean BMI during the third trimester of pregnancy (30.1 ± 3.9 vs 27.2 ± 3.5, P = 0.011), elevated CRP levels, and decreased HDL-cholesterol levels (6.39 ± 2.29 mg/L vs 4.28 ± 2.15 mg/L, P = 0.003 and 67 ± 14 mg/dl vs 82 ± 19 mg/dl, P = 0.009, respectively) compared to women with normal sleep study results. Offspring of mothers with SDB had a smaller mean head circumference SDS at birth (-0.95 ± 0.70 vs -0.30 ± 0.71, P = 0.004), with a distinctive pattern of catchup growth by the end of the first year of life (P = 0.018). They also had increased mean adiposity at birth measured by triceps and subscapular skinfolds (6.8 ± 1.8 mm vs 5.4 ± 1.2 mm, P =0.002 and 5.8 ± 1.3 mm vs 5.0 ± 1.0 mm, P =0.019, respectively), with a distinctive pattern of increased triceps thickness at age 3 years (P = 0.001). There was no significant difference in offspring length or weight between groups. Conclusions Our findings suggest that isolated maternal SDB during pregnancy affected longitudinal head circumference growth and adiposity acquisition in the fetus and during the first three years of life.

scholarly journals REVIEW OF SLEEP STUDY RESULTS BY PRIMARY CARE PROVIDERS WITH PATIENTS WHO HAVE SLEEP-DISORDERED BREATHING

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 60S
Author(s):  
Brian W. Carlin ◽  
Lori Dorycott ◽  
Lorie Smith ◽  
Spencer Carlin ◽  
Becky Rohosky
Keyword(s):  
Primary Care ◽  
Sleep Disordered Breathing ◽  
Primary Care Providers ◽  
Care Providers ◽  
Sleep Study ◽  
Study Results ◽  
Disordered Breathing

scholarly journals Prevalence and Patterns of Sleep-Disordered Breathing in Indian Heart Failure Population

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sajit Kishan ◽  
Mugula Sudhakar Rao ◽  
Padmakumar Ramachandran ◽  
Tom Devasia ◽  
Jyothi Samanth
Keyword(s):  
Heart Failure ◽  
Sleep Apnea ◽  
Sleep Disordered Breathing ◽  
Systolic Function ◽  
Left Ventricular ◽  
Sleep Study ◽  
Coronary Syndrome ◽  
Obstructive Sleep ◽  
Study Results ◽  
Disordered Breathing

Background. Sleep-disordered breathing (SDB) is a common yet a largely underdiagnosed entity in developing countries. It is one treatable condition that is known to adversely affect the mortality and morbidity in heart failure (HF). This study is one of the first attempts aimed at studying SDB in chronic HF patients from an Indian subcontinent. Objectives. The aim of this study was to study the prevalence, type, and characteristics of SDB in chronic HF patients and their association with HF severity and left ventricular (LV) systolic function and also to determine the relevance of SDB symptoms and screening questionnaires such as the Epworth Sleepiness Scale (ESS), Berlins questionnaire, and STOP-BANG score in predicting SDB in chronic HF patients. Methods. We enrolled 103 chronic heart failure patients aged more than 18 years. Patients with a history of SDB and recent acute coronary syndrome within 3 months were excluded. Relevant clinical data, anthropometric measures, echocardiographic parameters, and sleep apnea questionnaires were collected, and all patients underwent the overnight type 3 sleep study. Results. The overall prevalence of SDB in our study was high at 81.55% (84/103), with a predominant type of SDB being obstructive sleep apnea (59.2%). The occurrence of SDB was significantly associated with the male gender ( p = 0.002 ) and higher body mass index (BMI) values ( p = 0.01 ). SDB symptoms and questionnaires like ESS, STOP-BANG, and Berlins also did not have a significant association with the occurrence of SDB in HF patients. Conclusions. Our study showed a high prevalence of occult SDB predominantly OSA, in chronic HF patients. We advocate routine screening for occult SDB in HF patients.

Comparison of Clinical Symptoms and Severity of Sleep Disordered Breathing in Children with and without Cleft Lip and/or Palate

2017 ◽  
Vol 54 (5) ◽  
pp. 523-529 ◽  
Author(s):  
Joanna E Maclean ◽  
David Fitzsimons ◽  
Dominic Fitzgerald ◽  
Karen Waters
Keyword(s):  
Sleep Disordered Breathing ◽  
Cleft Lip ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Central Apnea ◽  
Sleep Study ◽  
Obstructive Sleep ◽  
Study Results ◽  
Disordered Breathing

Objective To determine whether the clinical presentation or severity of sleep disordered breathing differs between children with or without a history of cleft lip and/or palate (CL/P) presenting for sleep assessment. Design Retrospective chart review. Setting Tertiary care pediatric hospital cleft clinic, sleep clinic. Patients Children > 6 months of age presenting to the cleft clinic with sleep concerns and children without CL/P presenting to the sleep clinic in the same 2-year period. Main Outcomes Measures Clinical symptoms and overnight polysomnography (PSG) results. Results A total of 168 children (55 from cleft clinic, 113 from sleep clinic) were identified. Age at clinical review (6.6 ± 4.1 years versus 6.8 ± 4.0 years, P = ns), sex distribution (64.6% versus 58.4%, P = ns), and the presence of syndromes or significant medical conditions (12% versus 16%, P = ns) were similar between groups. Snoring was the reason for referral in 59% of children with CL/P and 69% of non-CL/P children ( P = ns). The only presenting feature that differentiated between the groups was a lower incidence of tonsillar enlargement in children with CL/P (33% versus 79%, chi-square 30.4, P < 0.001). Sleep study results showed similar apnea-hypopnea indices (6.2 ± 6.9 versus 7.9 ± 7.1 events/hr, P = ns) with more central apnea in children with CL/P (1.5 ± 1.5 versus 1.0 ± 1.0 events/hr, P = 0.017). Conclusions Snoring and obstructive sleep apnea are common in CL/P with less tonsillar enlargement than non-CL/P children. Children with CL/P have similar OSA severity compared to non-cleft children but more central apnea which may indicate differences in the control of breathing.

scholarly journals Mild maternal sleep-disordered breathing during pregnancy and offspring growth and adiposity in the first 3 years of life

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Avivit Brener ◽  
Yael Lebenthal ◽  
Sigal Levy ◽  
Galit Levi Dunietz ◽  
Orna Sever ◽  
...  
Keyword(s):  
Head Circumference ◽  
Sleep Disordered Breathing ◽  
Critical Role ◽  
Hdl Cholesterol ◽  
Laboratory Evaluation ◽  
Sleep Study ◽  
Childhood Growth ◽  
Protein Levels ◽  
Offspring Growth ◽  
Disordered Breathing

Abstract Sleep-disordered breathing (SDB) during pregnancy has been linked to adverse fetal outcomes. Since the intrauterine milieu plays a critical role in childhood growth, we explored the interactions between maternal SDB and offspring growth and adiposity patterns during infancy. Fifty-eight healthy women with uncomplicated pregnancies underwent an objective sleep study and laboratory evaluation during the third trimester, their offspring underwent a 3-year growth surveillance. The 14 (24.1%) women with SDB had a higher body mass index (BMI) (P = 0.003), elevated C-reactive protein levels (P = 0.003), and decreased HDL-cholesterol levels (P = 0.009) than the women without SDB. A general linear model evaluated the interactions between maternal SDB and offspring growth and adiposity measurements after controlling for gestational age and maternal and paternal BMIs. The offspring of mothers with SDB had a significantly smaller head circumference at birth (P = 0.004), with a distinctive pattern of catchup growth by the end of the first year of life (P = 0.018). Their growth pattern was distinguished by compromised birth weight-to-length, rapid catch-up growth, and an increase in both weight-to-length and triceps thickness by the age of three (P < 0.001 and P = 0.001, respectively). Our findings suggest that maternal SDB during pregnancy affects head circumference growth and adiposity acquisition from birth through infancy.

Features of the course and treatment of glaucoma during pregnancy

2020 ◽  
Vol 98 (3) ◽  
pp. 178-184
Author(s):  
T. V. Chernyakova ◽  
A. Yu. Brezhnev ◽  
I. R. Gazizova ◽  
A. V. Kuroyedov ◽  
A. V. Seleznev
Keyword(s):  
Pregnant Women ◽  
Laser Treatment ◽  
Progressive Disease ◽  
Clinical Course ◽  
The Other ◽  
Third Trimester ◽  
The Third ◽  
Chronic Progressive Disease ◽  
Hypotensive Therapy ◽  
Eye Pressure

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

scholarly journals Relationship between sleep-disordered breathing and perinatal outcome in pregnant women

2011 ◽  
Vol 25 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Sachiyo MIYAGAWA ◽  
Yoko EMORI ◽  
Atsuko KAWANO ◽  
Susumu SAKURAI ◽  
Takeshi TANIGAWA
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcome ◽  
Sleep Disordered Breathing ◽  
Disordered Breathing

scholarly journals A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nader Salari ◽  
Niloofar Darvishi ◽  
Behnam Khaledi-Paveh ◽  
Aliakbar Vaisi-Raygani ◽  
Rostam Jalali ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Meta Analysis ◽  
Physical And Mental Health ◽  
Third Trimester ◽  
Cross Sectional ◽  
The Third ◽  
Physical Problems ◽  
Meta Regression Analysis

Abstract Background Sleep disorders, which are among the foremost important medical care issues, are prevalent in pregnancy. The present study is a meta-analysis of the prevalence of insomnia in the third trimester of pregnancy. This study aims to systematically review the overall prevalence of insomnia in the third trimester of pregnancy through conducting a meta-analysis. Method The literature used in this meta-analysis for the topic discussed above were obtained through searching several databases, including SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed Science Direct and Google Scholar databases without time limitation until December 2020. Articles developed based on cross-sectional studies were included in the study. The heterogeneity of studies was investigated using the I2 index. Also, the possible effects of heterogeneity in the studied studies are investigated using meta-regression analysis. Result In 10 articles and 8798 participants aged between11–40, the overall prevalence of insomnia in the third trimester of pregnancy based on meta-analysis was 42.4% (95% CI: 32.9–52.5%). It was reported that as the sample size increases, the prevalence of insomnia in the third trimester of pregnancy increases. Conversely, as the year of research increases, the prevalence of insomnia in the third trimester of pregnancy decreases. Both of these differences were statistically significant (P < 0.05). Conclusion Insomnia was highly prevalent in the last trimester of pregnancy. Sleep disorders are neglected among pregnant women, and they are considered natural. While sleep disturbances can cause mental and physical problems in pregnant women, they can consequently cause problems for the fetus. As a result, maintaining the physical and mental health of pregnant mothers is very important. It is thus recommended that in addition to having regular visits during pregnancy, pregnant women should also be continuously monitored for sleep-related disorders.

The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use

Rheumatology ◽  
2021 ◽  
Author(s):  
Rugina I Neuman ◽  
Hieronymus T W Smeele ◽  
A H Jan Danser ◽  
Radboud J E M Dolhain ◽  
Willy Visser
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Disease Activity ◽  
Pregnant Women ◽  
Gestational Age ◽  
Third Trimester ◽  
Low Disease Activity ◽  
The Third ◽  
Observational Prospective Cohort Study ◽  
Plgf Ratio

Abstract Objectives An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels. Methods Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21–42 years, were included, with a median gestational age of 30 + 3 weeks. Results No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio &gt; 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11). Conclusion Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.

569 Correlation between age and initial findings of sleep disordered breathing in children with achondroplasia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A224-A225
Author(s):  
Fayruz Araji ◽  
Cephas Mujuruki ◽  
Brian Ku ◽  
Elisa Basora-Rovira ◽  
Anna Wani
Keyword(s):  
Sleep Apnea ◽  
Primary Care Physicians ◽  
Sleep Disordered Breathing ◽  
Upper Airway ◽  
Sleep Study ◽  
Surgical Interventions ◽  
Screening Guidelines ◽  
Obstructive Sleep ◽  
Children’S Sleep ◽  
Disordered Breathing

Abstract Introduction Achondroplasia (ACH) occurs approximately 1 in 20,000–30,000 live births. They are prone to sleep disordered breathing specifically due to the upper airway stenosis, enlarged head circumference, combined with hypotonia and limited chest wall size associated with scoliosis at times. The co-occurrence of sleep apnea is well established and can aide in the decision for surgical intervention, however it is unclear at what age children should be evaluated for sleep apnea. Screening is often delayed as during the daytime there is no obvious gas exchange abnormalities. Due to the rareness of this disease, large studies are not available, limiting the data for discussion and analysis to develop guidelines on ideal screening age for sleep disordered breathing in children with ACH. Methods The primary aim of this study is to ascertain the presence of sleep disorder breathing and demographics of children with ACH at time of first polysomnogram (PSG) completed at one of the largest pediatric sleep lab in the country. The secondary aim of the study is to identify whether subsequent polysomnograms were completed if surgical interventions occurred and how the studies differed over time with and without intervention. Retrospective review of the PSGs from patients with ACH, completed from 2017–2019 at the Children’s Sleep Disorders Center in Dallas, TX. Clinical data, demographics, PSG findings and occurrence of interventions were collected. Results Twenty-seven patients with the diagnosis of ACH met criteria. The average age at the time of their first diagnostic PSG was at 31.6 months of age (2.7 years), of those patients 85% had obstructive sleep apnea (OSA),51% had hypoxemia and 18% had hypercapnia by their first diagnostic sleep study. Of those with OSA, 50% were severe. Majority were females, 55%. Most of our patients were Hispanic (14%), Caucasian (9%), Asian (2%), Other (2%), Black (0%). Each patient had an average of 1.9 PSGs completed. Conclusion Our findings can help create a foundation for discussion of screening guidelines. These guidelines will serve to guide primary care physicians to direct these patients to an early diagnosis and treatment of sleep disordered breathing. Support (if any):

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