Validation of a sleep-disordered breathing screening questionnaire during pregnancy and comparison between mothers and bedpartners prediction of risk

Lauren A. Booker; Mark E. Howard; Susan P. Walker; Danielle L. Wilson

doi:10.1186/s12884-024-06753-z

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Validation of a sleep-disordered breathing screening questionnaire during pregnancy and comparison between mothers and bedpartners prediction of risk

Journal article

Open access

Peer reviewed

Validation of a sleep-disordered breathing screening questionnaire during pregnancy and comparison between mothers and bedpartners prediction of risk

Lauren A. Booker, Mark E. Howard, Susan P. Walker and Danielle L. Wilson

BMC Pregnancy and Childbirth, Vol.24, pp.1-8

2024

DOI: https://doi.org/10.1186/s12884-024-06753-z

PMID: 39215252

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Abstract

pregnancy

obstructive sleep apnea

Polysomnography

screening

hypertension

Background Sleep Disordered Breathing (SDB) in pregnant patients ranges from 3 to 27% and varies depending on gestational age and method used to diagnose. SDB increases the risk of advanced pregnancy complications such as gestational diabetes mellitus, pregnancy-induced hypertension, and preeclampsia. Screening and diagnosis of SDB during pregnancy remains a challenge, with existing screening tools underperforming during pregnancy. This study aimed to validate a previously developed model for predicting SDB during late pregnancy and compare the predictive value of bedpartner responses. Methods Ninety-six women in the third trimester of pregnancy underwent polysomnography and completed the Berlin Questionnaire (BQ), with 81 bedpartners completing the BQ about their pregnant partner. A subset of BQ items (snoring volume and tiredness upon awakening) along with BMI > 32 kg/m2was utilised to calculate the Wilson Optimized Model (WOM), which demonstrated strong predictive properties in development. Results SDB (RDI/hr ≥ 5) was detected in 43.8% of women. BQ identified 72% of pregnant mothers as high risk for SDB (Sensitivity = 83%, Specificity = 37%), compared to 29% of mothers identified by the WOM (Sensitivity = 45%, Specificity = 83%). At RDI of ≥ 15, the WOM correctly classified more women according to SDB risk than the BQ (76.0% vs. 41.7% cases correct,X2(1) = 23.42,p < .001), with no difference at RDI ≥ 5. Bedpartners were more likely to report high risk for SDB on the WOM than pregnant women themselves (38.3% vs. 28.4%), however predictive ability was not improved by bedpartner input (RDI ≥ 5 bedpartner AUC = 0.69 v mother AUC = 0.73). Conclusion BQ largely overestimates the prevalence of SDB in pregnancy compared to the WOM which underestimates. Utilising bedpartner responses didn’t improve screening for SDB in late pregnancy. More work is needed to develop a pregnancy-specific tool for quick and accurate screening for SDB.

Details

Title: Validation of a sleep-disordered breathing screening questionnaire during pregnancy and comparison between mothers and bedpartners prediction of risk
Authors: Lauren A. Booker (Corresponding Author) - La Trobe University
Mark E. Howard - The University of Melbourne
Susan P. Walker - Mercy Hospital for Women
Danielle L. Wilson - The University of Queensland
Publication details: BMC Pregnancy and Childbirth, Vol.24, pp.1-8
Publisher: BioMed Central Ltd.
Date published: 2024
DOI: 10.1186/s12884-024-06753-z
ISSN: 1471-2393
PMID: 39215252
Copyright note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/.
Grant note: This research was supported by the Austin Medical Research Foundation and Medical Research Foundation for Women and Babies. D. Wilson was supported by a National Health and Medical Research Council (NHMRC) postgraduate scholarship for the original work.
Organisation Unit: Thompson Institute
Language: English
Record Identifier: 991219692702621
Output Type: Journal article

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