Indian Journal of Sleep Medicine

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VOLUME 12 , ISSUE 4 ( October-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

Sleep Disordered Breathing-induced Endothelial Dysfunction and Its Association with Fetomaternal Outcomes in Preeclampsia

HP Anand, Tulsi Adhikari, Gulshan Bano

Keywords : Adverse fetal outcomes, Adverse maternal outcomes, Endothelial dysfunction, Preeclampsia, Sleep disordered breathing.

Citation Information : Anand H, Adhikari T, Bano G. Sleep Disordered Breathing-induced Endothelial Dysfunction and Its Association with Fetomaternal Outcomes in Preeclampsia. Indian Sleep Med 2017; 12 (4):53-59.

DOI: 10.5005/jp-journals-10069-0011

License: CC BY-SA 4.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: There is a close association between sleep disordered breathing (SDB) and preeclampsia (PE). Endothelial dysfunction (ED) is the common final pathway in the development of hypertension in both the conditions. Materials and methods: Totally, 25 women with new-onset hypertension of pregnancy and 25 age-, body mass index (BMI)-, and gestational age-matched normotensive pregnant women were subjected to polysomnography (PSG) and EndoPAT test. The maternal and fetal outcomes of all the subjects were noted. Results: The SDB and ED occur more frequently in PE (64 vs 24%; p = 0.01 and 72 vs 28%; p = 0.002 respectively) compared with normotensive pregnant women. Mean respiratory distress index (RDI) was higher (8.28 ± 7.9 vs 4.2 ± 2.7) and mean reactive hyperemic index (RHI) lower (1.46 ± 0.33 vs 1.88 ± 7.9; 0.001) in PE. The mean blood pressure (MBP) in cases tended to correlate positively with RDI and negatively with RHI. There was a significant negative correlation between RDI and RHI (r = -0.637; p = 0.001). About 87.5% of the cases who had SDB also had ED, whereas only 12.5% of the cases who did not suffer from SDB had an ED (p = 0.02), and this trend was also observed in the controls (p = 0.001). It was seen on subgroup analysis that the women with PE, who had both SDB and ED, had poorer maternal and fetal outcomes than those who had neither of the conditions. Conclusion: The SDB and ED are closely associated with PE. The ED occurs more frequently and with greater severity in preeclamptic women who have SDB and is associated with adverse fetomaternal outcomes


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