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196. New-onset sleep apnea during pregnancy Francesca Facco1, David Ouyang2, Phyllis Zee3, William Grobman1 1 Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, IL, 2Northshore University HealthSystem, Obstetrics and Gynecology, Evanston, IL, 3Northwestern University, Neurology, Chicago, IL OBJECTIVE: Although the hormonal and physiologic changes of pregnancy may increase the risk of sleep apnea (SA), it remains unknown to what extent women who do not have SA develop it as pregnancy progresses. The objective of this study was to characterize the incidence of and risk factors for new-onset SA during pregnancy among a population at risk. STUDY DESIGN: Pregnant women with chronic hypertension, pre-gestational diabetes, obesity, and/or a history of preeclampsia were recruited to undergo a sleep evaluation with the Watch-PAT100 (WP100), an ambulatory device designed to diagnose SA. Participants wore the device in early pregnancy (6-20 weeks) and again in the third trimester (≥28 weeks). SA was defined as an apnea-hyponea index (AHI) of ≥5. Early-persistent SA was defined as AHI of ≥ 5 in early and late pregnancy. New-onset SA was defined as an AHI of < 5 in early pregnancy, but ≥ 5 on re- test in the third trimester. Characteristics of women early- persistent SA and those with and without new-onset SA were compared using ANOVA, and χ square tests as appropriate. RESULTS: 78 women had valid early and third trimester WP100 studies. 19 women (34%) had early-persistent SA. Only 2 women who had SA in early pregnancy tested negative in the third trimester. Of the 57 women who tested negative for SA in early pregnancy, 13 (23%) developed new-onset SA. Characteristics of women with early-persistent SA and those with and without new-onset SA are presented in the Table. Women with early-persistent SA had a higher BMI and a higher incidence of chronic hypertension. Demographic and clinical characteristics of women with new onset SA were similar to those who never developed SA. CONCLUSION: New-onset SA occurs in over 20% of high-risk women who initially test negative for SA in early pregnancy however, these women appear to have different characteristics than women with early- persistent SA. The clinical significance of new- onset SA in pregnancy is yet to be determined. Larger studies are needed to better understand the epidemiology of new-onset SA associated with pregnancy.
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