Dr Rachael Nugent1,2, Prof Caroline de Costa3, Assoc. Prof. Lauren Kearney2,5, Dr Rebekah Shakhovskoy1,3,4, Dr Elise Gilbertson1, Dr Shiv Erigadoo1, Professor Leonie Callaway2,5
1The Sunshine Coast Hospital And Health Service, Birtinya, Australia, 2The University of Queensland, Herston, Australia, 3The Cairns Institute, James Cook University, Cairns, Australia, 4Griffith University, Sunshine Coast, Australia, 5University of the Sunshine Coast, Sunshine Coast, Australia, 6Metro North Health Service, Herston, Australia
Biography:
Biography to come
Abstract:
Background: Obstructive Sleep Apnoea (OSA) affects up to 30% of pregnancies and may be associated with adverse maternal and neonatal outcomes. Continuous Positive Airway Pressure (CPAP) may be an effective treatment for OSA during pregnancy. There is a strong correlation between increasing Body Mass Index (BMI) and OSA requiring treatment.
Aim: To examine the feasibility and acceptability of screening women with a BMI>35 for OSA in pregnancy, with randomisation to treatment with CPAP or no CPAP for women with OSA.
Methods: This study is a single centre, pilot randomised control trial (RCT). Feasibility was assessed by recruitment, acceptability of the sleep study and treatment, and adherence.
Results: 96 women with BMI>35 before 26 completed weeks of pregnancy were invited from the Sunshine Coast University Hospital and Health Service. 37% (n=36) of women invited to the trial enrolled and 26% (n=27) of the women invited completed as per protocol. Five women were diagnosed as having an apnea-hypopnea index (AHI)>15 and were randomised to receive treatment with CPAP (n=4) or no CPAP (n=1) until birth. 20 women had an AHI below the threshold for randomisation. 11 women withdrew – nine prior to sleep study, one following an inconclusive sleep study, and one after randomisation to treatment. Participants generally found the sleep study acceptable, and adherence to CPAP was variable.
Discussion: A definitive trial screening women for OSA and subsequent randomisation to treatment or no treatment may be feasible. Screening and treatment of OSA in pregnancy is acceptable to women and well tolerated. Further trials should evaluate clinical and cost-effectiveness, investigate partial treatment effects, and ensure neonatal outcome follow-up to at least 2 years of age.
Trial Registration: ACTRN12621001523897
Keywords
Pregnancy, continuous positive airway pressure, obstructive sleep apnoea