A systematic review and quantitative assessment of sleep-disordered breathing during pregnancy and perinatal outcomes

Previous investigations have suggested a strong association between sleep-disordered breathing (SDB) during pregnancy and perinatal outcomes. However, the results of the following replication studies were not always concordant. Therefore, this meta-analysis was conducted to evaluate the more reliable estimate. A systematic literature search was performed on PubMed, Springer Link, and EMBASE to identify all eligible studies published before August 2013. Summary odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using fixed or random effects model. A total of 24 publications met the inclusion criteria and were included in this meta-analysis. Findings demonstrated that moderate-to-severe SDB during pregnancy was associated with gestational diabetes mellitus (OR = 1.78; 95 % CI, 1.29 to 2.46), pregnancy-related hypertension (OR = 2.38; 95 % CI, 1.63 to 3.47), preeclampsia (OR = 2.19; 95 % CI, 1.71 to 2.80), preterm delivery (OR = 1.98; 95 % CI, 1.59 to 2.48), low birth weight (OR = 1.75; 95 % CI, 1.33 to 2.32), neonatal intensive care unit (NICU) admission (OR = 2.43; 95 % CI, 1.61 to 3.68), intrauterine growth restriction (OR = 1.44; 95 % CI, 1.22 to 1.71), and Apgar score of < 7 at 1 min (OR = 1.78; 95 % CI, 1.10 to 2.91) based on all studies but not gestational age and birth weight. This meta-analysis revealed that moderate-to-severe SDB during pregnancy may be associated with most of adverse perinatal outcomes. Further well-designed studies are warranted to confirm our findings.