Can a Mother’s Obstructive Sleep Apnoea Affect Her Baby?

Can a baby be affected by his or her mother’s obstructive sleep apnoea? This question arises from the fact that in some studies, maternal hypertension and cardio-respiratory disease has given rise to intrauterine growth restriction (IUGR) among affected foetuses. A lot of experts have credited this to the fact that growth restriction of foetuses in the wombs of mothers with the said health problems may be caused by factors such as impaired vascular perfusion or inflammatory activation that may contribute to impaired oxygen and nutrient exchange. Lately some studies say that these factors are not only present in hypertension and cardiopulmonary problems but in a common sleep disorder called sleep apnoea.

Sleep apnoea is a condition wherein the upper airway collapses during sleep, resulting in cessation of breathing and decreased oxygen yet increased carbon dioxide levels in the blood. It is said that obstructive sleep apnoea can activate the sympathetic nervous system and inflammatory pathways, thus it may be an unsuspected contributor to foetal growth restriction and stillbirth.

So can maternal sleep apnoea really affect the baby? A recent study published in PLoS One tried to determine whether obstructive sleep apnoea (OSA) is associated with reduced foetal growth, and whether lower oxygen levels at night could lead to foetal heart rate changes. This study is a prospective observational study, screening 371 women in the second trimester for OSA symptoms. About 41 subsequently underwent overnight sleep studies to diagnose OSA. Third trimester foetal growth was assessed using ultrasound. Foetal heart rate monitoring accompanied the sleep study. Cord blood was taken at delivery, to measure key regulators of foetal growth.

The results of this study showed that out of 371 women screened, 108 (29%) were high risk for OSA. The investigators learned that OSA may be associated with reduced foetal growth in late pregnancy. However, they claimed that further evaluation is warranted to establish whether OSA may be an important contributor to adverse perinatal outcome, including stillbirth.

Indeed obstructive sleep apnoea may be associated with impaired foetal growth in late pregnancy. In this study, the authors have found that even mild OSA may be associated with significant growth retardations. OSA may thus be an important contributor to stillbirth. This is why obstructive sleep apnoea in pregnant should be treated as soon as possible, to avoid poor pregnancy outcomes.

You can read more of the results here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722214/

Reference:

Fung AM, Wilson DL, Lappas M, Howard M, Barnes M, O'Donoghue F, Tong S, Esdale H, Fleming G, Walker SP. Effects of maternal obstructive sleep apnoea on fetal growth: a prospective cohort study. PLoS One. 2013 Jul 24;8(7):e68057.

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