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Medical/Surgical/Diseases/Complications

Poster Session 2

(502) Does obstructive sleep apnea in obese patients affect neonatal outcomes?

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

Rates of obesity continue to rise within the United States and with it, the rates of obstructive sleep apnea (OSA). This study aims to determine if there is an association between the presence of OSA in obese pregnant patients and neonatal outcomes compared to obese pregnant patients without OSA.

Study Design:

This was a retrospective cohort study of all pregnant patients with BMI over 40 kg/m2 who delivered between Jan. 1, 2011 and Dec. 31, 2020 at a single-center institution. Maternal medical history, neonatal outcomes including APGAR scores at 1 and 5 minute, need for neonatal continuous positive airway pressure (CPAP), neonatal intensive care unit (NICU) admission, mechanical ventilation (MV) requirement, development of transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) were collected. Descriptive and comparative analysis with chi-square and T-test was performed. 

Results:

870 cases were analyzed and 70 (8%) of patients were diagnosed with OSA prior to delivery. Average BMI at delivery for patients with OSA was 55.9 kg/m2 and those without was 50.8 kg/m2. The presence of OSA in obese pregnant patients was significantly associated with neonatal CPAP (p < 0.01), NICU admission (p < 0.01), and development of RDS (p < 0.01) in comparison to those born to mothers without OSA. There was no significant association between presence of OSA and neonatal MV (p= 0.581) and development of TTN (p= 0.095). APGAR scores at 1 minute were significantly lower in neonates born to obese mothers with OSA in comparison to those without OSA (7 vs. 8, p= 0.02). APGAR scores at 5 minutes did not differ significantly between groups (8 vs. 8, p= 0.075). 

Conclusion:

This study shows that OSA in an obese pregnant patient prior to delivery is associated with increased neonatal oxygen support and escalated care in the NICU, compared to those without OSA. This highlights the importance of appropriate OSA diagnosis and treatment in order to decrease likelihood of neonatal respiratory complications. Additionally, counseling obese pregnant patients of increased risks of OSA is critical.